Provider Demographics
NPI:1881693653
Name:HEALTH STRIDES, INC.
Entity type:Organization
Organization Name:HEALTH STRIDES, INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:LEA
Authorized Official - Middle Name:MARIE
Authorized Official - Last Name:WOLSONCROFT
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:205-824-0775
Mailing Address - Street 1:4268 CAHABA HEIGHTS CT
Mailing Address - Street 2:SUITE 103
Mailing Address - City:VESTAVIA
Mailing Address - State:AL
Mailing Address - Zip Code:35243-5711
Mailing Address - Country:US
Mailing Address - Phone:205-824-0775
Mailing Address - Fax:205-313-5791
Practice Address - Street 1:4268 CAHABA HEIGHTS CT
Practice Address - Street 2:SUITE 103
Practice Address - City:VESTAVIA
Practice Address - State:AL
Practice Address - Zip Code:35243-5711
Practice Address - Country:US
Practice Address - Phone:205-824-0775
Practice Address - Fax:205-313-5791
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-07-14
Last Update Date:2017-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL1121163336C0004X, 3336S0011X, 3336C0003X, 333600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes333600000XSuppliersPharmacy
No3336C0004XSuppliersPharmacyCompounding Pharmacy
No3336S0011XSuppliersPharmacySpecialty Pharmacy
No3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL100003310Medicaid
AL100003310Medicaid
AL6743720001Medicare NSC