Provider Demographics
NPI:1376677229
Name:RIVERBEND CENTER FOR MENTAL HEALTH PHARMACY
Entity Type:Organization
Organization Name:RIVERBEND CENTER FOR MENTAL HEALTH PHARMACY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF PHARMACY
Authorized Official - Prefix:MRS
Authorized Official - First Name:PAM
Authorized Official - Middle Name:C
Authorized Official - Last Name:ASHLEY
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:256-768-7500
Mailing Address - Street 1:635 W COLLEGE ST
Mailing Address - Street 2:
Mailing Address - City:FLORENCE
Mailing Address - State:AL
Mailing Address - Zip Code:35630-5313
Mailing Address - Country:US
Mailing Address - Phone:256-768-7500
Mailing Address - Fax:256-768-7471
Practice Address - Street 1:635 W COLLEGE ST
Practice Address - Street 2:
Practice Address - City:FLORENCE
Practice Address - State:AL
Practice Address - Zip Code:35630-5313
Practice Address - Country:US
Practice Address - Phone:256-768-7500
Practice Address - Fax:256-768-7471
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-15
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL150024261QM0801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL0106648OtherNABP OR NCPDP NUMBER