Provider Information for 1811548746
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SCPG ALABAMA LLC
Other Names:Doing Business As:EXPRESS RX OF HAMILTONOrganization Subpart: NO
NPI: 1811548746
Last Updated: 2020-10-12
Certification Date: 2020-10-12
Certification Date: 2020-10-12
Details
| Name | Value | ||||||||
|---|---|---|---|---|---|---|---|---|---|
| NPI | 1811548746 | ||||||||
| Enumeration Date | 2019-09-23 | ||||||||
| NPI Type | NPI-2 Organization | ||||||||
| Status | Active | ||||||||
| Authorized Official Information | Name: GALEN PERKINS Title: Member Phone: 5012584399 | ||||||||
| Mailing Address | PO BOX 34407 PMB 53760 LITTLE ROCK, AR 72203-4407 United States Phone: 918-640-9270 | Fax:205-921-1220 | ||||||||
| Primary Practice Address | 1508 MILITARY ST S HAMILTON, AL 35570-5006 United States Phone: 205-921-7465 | Fax:205-921-7896 | ||||||||
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