Provider Demographics
NPI:1396581385
Name:MEDSPLUS CONSULTING LLC
Entity type:Organization
Organization Name:MEDSPLUS CONSULTING LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CONSULTANT PHARMACIST
Authorized Official - Prefix:
Authorized Official - First Name:PAULINE
Authorized Official - Middle Name:KENNARD
Authorized Official - Last Name:LONG
Authorized Official - Suffix:
Authorized Official - Credentials:PHARMD
Authorized Official - Phone:205-650-4636
Mailing Address - Street 1:215 RICHARD ARRINGTON JR BLVD N STE 801
Mailing Address - Street 2:
Mailing Address - City:BIRMINGHAM
Mailing Address - State:AL
Mailing Address - Zip Code:35203-3719
Mailing Address - Country:US
Mailing Address - Phone:205-650-4636
Mailing Address - Fax:205-650-4640
Practice Address - Street 1:215 RICHARD ARRINGTON JR BLVD N STE 801
Practice Address - Street 2:
Practice Address - City:BIRMINGHAM
Practice Address - State:AL
Practice Address - Zip Code:35203-3719
Practice Address - Country:US
Practice Address - Phone:205-650-4636
Practice Address - Fax:205-650-4640
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-07-08
Last Update Date:2024-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336L0003XSuppliersPharmacyLong Term Care Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL300662Medicaid