Provider Demographics
NPI:1437532843
Name:SRX LLC
Entity Type:Organization
Organization Name:SRX LLC
Other - Org Name:SARALAND PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT/SUPERVISING PHARMACIST
Authorized Official - Prefix:
Authorized Official - First Name:KELLY
Authorized Official - Middle Name:
Authorized Official - Last Name:STINSON
Authorized Official - Suffix:
Authorized Official - Credentials:PHARMD
Authorized Official - Phone:251-675-3333
Mailing Address - Street 1:106A SARALAND LOOP RD
Mailing Address - Street 2:
Mailing Address - City:SARALAND
Mailing Address - State:AL
Mailing Address - Zip Code:36571
Mailing Address - Country:US
Mailing Address - Phone:251-675-3333
Mailing Address - Fax:251-675-9333
Practice Address - Street 1:106A SARALAND LOOP RD
Practice Address - Street 2:
Practice Address - City:SARALAND
Practice Address - State:AL
Practice Address - Zip Code:36571
Practice Address - Country:US
Practice Address - Phone:251-675-3333
Practice Address - Fax:251-675-9333
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-07-02
Last Update Date:2023-11-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
333600000X
AL1144963336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No333600000XSuppliersPharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL176556Medicaid
2152956OtherPK