Provider Demographics
NPI:1346636008
Name:MEDSHOP PHARMACY INC
Entity Type:Organization
Organization Name:MEDSHOP PHARMACY INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:SUSAN
Authorized Official - Middle Name:
Authorized Official - Last Name:CALLAHAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:205-919-0542
Mailing Address - Street 1:7895 HIGHWAY 119 STE 1
Mailing Address - Street 2:
Mailing Address - City:ALABASTER
Mailing Address - State:AL
Mailing Address - Zip Code:35007-7554
Mailing Address - Country:US
Mailing Address - Phone:205-621-8407
Mailing Address - Fax:205-621-8408
Practice Address - Street 1:7895 HIGHWAY 119
Practice Address - Street 2:ST 1
Practice Address - City:ALABASTER
Practice Address - State:AL
Practice Address - Zip Code:35007-7553
Practice Address - Country:US
Practice Address - Phone:205-621-8407
Practice Address - Fax:205-621-8408
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-04-09
Last Update Date:2016-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes333600000XSuppliersPharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL7445150001Medicare NSC