Provider Demographics
NPI:1477665453
Name:MED- SURG PHARMACY INC
Entity Type:Organization
Organization Name:MED- SURG PHARMACY INC
Other - Org Name:MED SURG PHARMACY INC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PHARMACIST
Authorized Official - Prefix:
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:
Authorized Official - Last Name:DUNCAN
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:256-355-2828
Mailing Address - Street 1:2828 HIGHWAY 31 S
Mailing Address - Street 2:STE 150
Mailing Address - City:DECATUR
Mailing Address - State:AL
Mailing Address - Zip Code:35603-1510
Mailing Address - Country:US
Mailing Address - Phone:877-540-4748
Mailing Address - Fax:801-716-4872
Practice Address - Street 1:2828 HIGHWAY 31 S
Practice Address - Street 2:STE 150
Practice Address - City:DECATUR
Practice Address - State:AL
Practice Address - Zip Code:35603-1510
Practice Address - Country:US
Practice Address - Phone:256-355-2828
Practice Address - Fax:256-355-1558
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-31
Last Update Date:2013-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
333600000X
AL1067603336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No333600000XSuppliersPharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
1991320OtherPK