Provider Demographics
NPI:1720294994
Name:HELIOS INC.
Entity Type:Organization
Organization Name:HELIOS INC.
Other - Org Name:MEDICAL VILLAGE PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PHARMACIST
Authorized Official - Prefix:MR
Authorized Official - First Name:STAVROS
Authorized Official - Middle Name:L
Authorized Official - Last Name:LADAS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:251-456-4172
Mailing Address - Street 1:426 S CRAFT HWY
Mailing Address - Street 2:
Mailing Address - City:CHICKASAW
Mailing Address - State:AL
Mailing Address - Zip Code:36611-2213
Mailing Address - Country:US
Mailing Address - Phone:251-456-4172
Mailing Address - Fax:251-456-4175
Practice Address - Street 1:426 S CRAFT HWY
Practice Address - Street 2:
Practice Address - City:CHICKASAW
Practice Address - State:AL
Practice Address - Zip Code:36611-2213
Practice Address - Country:US
Practice Address - Phone:251-456-4172
Practice Address - Fax:251-456-4175
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-15
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL1067463336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL0123555Medicare UPIN