Provider Demographics
NPI:1841366697
Name:NATIONAL MEDICINE CENTER
Entity type:Organization
Organization Name:NATIONAL MEDICINE CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHARMACIST OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:JENNIFER
Authorized Official - Middle Name:LYN
Authorized Official - Last Name:SETZER
Authorized Official - Suffix:
Authorized Official - Credentials:PHARM D
Authorized Official - Phone:205-884-4550
Mailing Address - Street 1:608 MARTIN ST SOUTH
Mailing Address - Street 2:
Mailing Address - City:PELL CITY
Mailing Address - State:AL
Mailing Address - Zip Code:35128
Mailing Address - Country:US
Mailing Address - Phone:205-884-4550
Mailing Address - Fax:205-884-4553
Practice Address - Street 1:608 MARTIN ST SOUTH
Practice Address - Street 2:
Practice Address - City:PELL CITY
Practice Address - State:AL
Practice Address - Zip Code:35128
Practice Address - Country:US
Practice Address - Phone:205-884-4550
Practice Address - Fax:205-884-4553
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-24
Last Update Date:2008-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes333600000XSuppliersPharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL5646550001Medicare NSC