Provider Demographics
NPI:1942751847
Name:QC PHARMACY LLC
Entity Type:Organization
Organization Name:QC PHARMACY LLC
Other - Org Name:QC PHARMACY LLC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PHARMACIST
Authorized Official - Prefix:
Authorized Official - First Name:BRETT
Authorized Official - Middle Name:
Authorized Official - Last Name:ENABNIT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:256-990-3267
Mailing Address - Street 1:7500 HIGHWAY 72 W
Mailing Address - Street 2:
Mailing Address - City:MADISON
Mailing Address - State:AL
Mailing Address - Zip Code:35758-9554
Mailing Address - Country:US
Mailing Address - Phone:256-517-8317
Mailing Address - Fax:256-715-0058
Practice Address - Street 1:7500 HIGHWAY 72 W
Practice Address - Street 2:
Practice Address - City:MADISON
Practice Address - State:AL
Practice Address - Zip Code:35758-9554
Practice Address - Country:US
Practice Address - Phone:256-517-8317
Practice Address - Fax:256-715-0058
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-10-17
Last Update Date:2018-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
333600000X
AL1146863336C0003X
AL1142843336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No333600000XSuppliersPharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
2166646OtherPK