Provider Demographics
NPI:1770835928
Name:NATIONAL CENTERS FOR PAIN MANAGEMENT AND RESEARCH
Entity Type:Organization
Organization Name:NATIONAL CENTERS FOR PAIN MANAGEMENT AND RESEARCH
Other - Org Name:NATIONAL PAIN CUSTOM PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PHARMACIST IN CHARGE
Authorized Official - Prefix:MS
Authorized Official - First Name:FRANCES
Authorized Official - Middle Name:C
Authorized Official - Last Name:HARBISON
Authorized Official - Suffix:
Authorized Official - Credentials:PHARM D
Authorized Official - Phone:205-777-3078
Mailing Address - Street 1:860 MONTCLAIR RD
Mailing Address - Street 2:SUITE 955
Mailing Address - City:BIRMINGHAM
Mailing Address - State:AL
Mailing Address - Zip Code:35213-1923
Mailing Address - Country:US
Mailing Address - Phone:205-777-3078
Mailing Address - Fax:
Practice Address - Street 1:860 MONTCLAIR RD
Practice Address - Street 2:SUITE 955
Practice Address - City:BIRMINGHAM
Practice Address - State:AL
Practice Address - Zip Code:35213-1923
Practice Address - Country:US
Practice Address - Phone:205-777-3078
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-10-12
Last Update Date:2013-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL113990333600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes333600000XSuppliersPharmacy