Provider Demographics
NPI:1912205758
Name:BAITSHOP INVESTMENTS, INC.
Entity Type:Organization
Organization Name:BAITSHOP INVESTMENTS, INC.
Other - Org Name:HELENA HOMETOWN PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT/OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:WILMER
Authorized Official - Middle Name:SCOTT
Authorized Official - Last Name:ARLEDGE
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:205-745-3979
Mailing Address - Street 1:5129 HIGHWAY 17
Mailing Address - Street 2:
Mailing Address - City:HELENA
Mailing Address - State:AL
Mailing Address - Zip Code:35080-3514
Mailing Address - Country:US
Mailing Address - Phone:205-745-3979
Mailing Address - Fax:
Practice Address - Street 1:5129 HIGHWAY 17
Practice Address - Street 2:
Practice Address - City:HELENA
Practice Address - State:AL
Practice Address - Zip Code:35080-3514
Practice Address - Country:US
Practice Address - Phone:205-745-3979
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-03-02
Last Update Date:2011-03-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL1135253336C0003X
3336H0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No3336H0001XSuppliersPharmacyHome Infusion Therapy Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL113525OtherALABAMA BOARD OF PHARMACY PERMIT NUMBER