Provider Demographics
NPI:1659886356
Name:MED360RX
Entity Type:Organization
Organization Name:MED360RX
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING PARTNER PHARMACIST
Authorized Official - Prefix:MR
Authorized Official - First Name:DEVIN
Authorized Official - Middle Name:KEITH
Authorized Official - Last Name:SMITH
Authorized Official - Suffix:
Authorized Official - Credentials:PHARMD
Authorized Official - Phone:205-495-4907
Mailing Address - Street 1:PO BOX 1677
Mailing Address - Street 2:
Mailing Address - City:WINFIELD
Mailing Address - State:AL
Mailing Address - Zip Code:35594-1416
Mailing Address - Country:US
Mailing Address - Phone:205-487-8020
Mailing Address - Fax:205-487-8022
Practice Address - Street 1:125 BOB LAWRENCE DRIVE SUITE C
Practice Address - Street 2:
Practice Address - City:WINFIELD
Practice Address - State:AL
Practice Address - Zip Code:35594
Practice Address - Country:US
Practice Address - Phone:205-487-8020
Practice Address - Fax:205-487-8022
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-12-05
Last Update Date:2017-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL1147663336C0003X
1147663336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy