Provider Demographics
NPI:1255807350
Name:FORD CITY RX
Entity type:Organization
Organization Name:FORD CITY RX
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:MANAGING MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:
Authorized Official - Last Name:SIGMON
Authorized Official - Suffix:
Authorized Official - Credentials:PHARMD
Authorized Official - Phone:256-446-8400
Mailing Address - Street 1:PO BOX 2584
Mailing Address - Street 2:
Mailing Address - City:MUSCLE SHOALS
Mailing Address - State:AL
Mailing Address - Zip Code:35662-2584
Mailing Address - Country:US
Mailing Address - Phone:256-446-8400
Mailing Address - Fax:256-446-9656
Practice Address - Street 1:14490 COUNTY LINE RD
Practice Address - Street 2:SUITE B
Practice Address - City:MUSCLE SHOALS
Practice Address - State:AL
Practice Address - Zip Code:35661
Practice Address - Country:US
Practice Address - Phone:256-446-8400
Practice Address - Fax:256-446-9656
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-10-17
Last Update Date:2023-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL228468Medicaid