Provider Demographics
NPI:1609948736
Name:PERSONAL TOUCH HEALTHCARE AND PHARMACY
Entity Type:Organization
Organization Name:PERSONAL TOUCH HEALTHCARE AND PHARMACY
Other - Org Name:PERSONAL TOUCH HEALTHCARE AND PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:CHIP
Authorized Official - Middle Name:
Authorized Official - Last Name:BALDWIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:256-350-4782
Mailing Address - Street 1:PO BOX 3074
Mailing Address - Street 2:
Mailing Address - City:DECATUR
Mailing Address - State:AL
Mailing Address - Zip Code:35602-3074
Mailing Address - Country:US
Mailing Address - Phone:256-351-0404
Mailing Address - Fax:
Practice Address - Street 1:824 6TH AVE SE
Practice Address - Street 2:
Practice Address - City:DECATUR
Practice Address - State:AL
Practice Address - Zip Code:35601-3022
Practice Address - Country:US
Practice Address - Phone:256-351-0404
Practice Address - Fax:256-351-2073
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-14
Last Update Date:2018-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL111080332B00000X, 3336C0003X
333600000X, 3336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
No333600000XSuppliersPharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL100003573Medicaid
1995299OtherPK
1995299OtherPK