Provider Demographics
NPI:1629052360
Name:S & S PHARMACEUTICALS LLC
Entity Type:Organization
Organization Name:S & S PHARMACEUTICALS LLC
Other - Org Name:THE PHARMACY IN MOUNT OLIVE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:STEVE
Authorized Official - Middle Name:
Authorized Official - Last Name:MULLENIX
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:205-631-1201
Mailing Address - Street 1:2648 MOUNT OLIVE RD
Mailing Address - Street 2:
Mailing Address - City:MOUNT OLIVE
Mailing Address - State:AL
Mailing Address - Zip Code:35117-3925
Mailing Address - Country:US
Mailing Address - Phone:205-631-1201
Mailing Address - Fax:205-608-1596
Practice Address - Street 1:2648 MOUNT OLIVE RD
Practice Address - Street 2:
Practice Address - City:MOUNT OLIVE
Practice Address - State:AL
Practice Address - Zip Code:35117-3925
Practice Address - Country:US
Practice Address - Phone:205-631-1201
Practice Address - Fax:205-608-1596
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-12-06
Last Update Date:2014-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
332B00000X, 333600000X
AL1127293336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No332B00000XSuppliersDurable Medical Equipment & Medical Supplies
No333600000XSuppliersPharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
1995724OtherPK
AL100003666Medicaid
5667010001Medicare NSC