Provider Demographics
NPI:1497055347
Name:HOWARD PHARMACY LLC
Entity Type:Organization
Organization Name:HOWARD PHARMACY LLC
Other - Org Name:MIDTOWN PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:CLINTON
Authorized Official - Middle Name:R
Authorized Official - Last Name:HOWARD
Authorized Official - Suffix:
Authorized Official - Credentials:PHARM D
Authorized Official - Phone:251-479-2424
Mailing Address - Street 1:2152 AIRPORT BLVD STE 107
Mailing Address - Street 2:
Mailing Address - City:MOBILE
Mailing Address - State:AL
Mailing Address - Zip Code:36606-1751
Mailing Address - Country:US
Mailing Address - Phone:251-479-2424
Mailing Address - Fax:251-479-5234
Practice Address - Street 1:2152 AIRPORT BLVD STE 107
Practice Address - Street 2:
Practice Address - City:MOBILE
Practice Address - State:AL
Practice Address - Zip Code:36606-1751
Practice Address - Country:US
Practice Address - Phone:251-479-2424
Practice Address - Fax:251-479-5234
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-10-26
Last Update Date:2021-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
333600000X
AL1096683336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No333600000XSuppliersPharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL126563Medicaid
2127460OtherPK
AL12632Medicaid