Provider Demographics
NPI:1639288467
Name:CALHOUN PHARMACY SERVICES INC
Entity type:Organization
Organization Name:CALHOUN PHARMACY SERVICES INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SEC TREASURER
Authorized Official - Prefix:MRS
Authorized Official - First Name:CINDY
Authorized Official - Middle Name:M
Authorized Official - Last Name:CALHOUN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:256-237-2751
Mailing Address - Street 1:3320 HENRY RD
Mailing Address - Street 2:
Mailing Address - City:ANNISTON
Mailing Address - State:AL
Mailing Address - Zip Code:36207-6344
Mailing Address - Country:US
Mailing Address - Phone:256-236-7611
Mailing Address - Fax:256-237-9708
Practice Address - Street 1:3320 HENRY RD
Practice Address - Street 2:
Practice Address - City:ANNISTON
Practice Address - State:AL
Practice Address - Zip Code:36207-6344
Practice Address - Country:US
Practice Address - Phone:256-236-7611
Practice Address - Fax:256-237-9708
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-29
Last Update Date:2008-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL222243336S0011X, 3336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No3336S0011XSuppliersPharmacySpecialty Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL100000132Medicaid
AL0123909OtherNDBBP