Basic Information
| Provider Information | |||||||||
| NPI: | 1356606792 | ||||||||
| EntityType: | 2 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | HMR OF ALABAMA INC | ||||||||
| LastName: | |||||||||
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| OtherOrganizationName: | HMR OF ALABAMA RLH PHARMACY | ||||||||
| OtherOrganizationType: | 3 | ||||||||
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| Mailing Information | |||||||||
| Address1: | HMR OF ALABAMA RLH PHARMACY | ||||||||
| Address2: | P.O. BOX 5285 | ||||||||
| City: | ANDERSON | ||||||||
| State: | SC | ||||||||
| PostalCode: | 29623 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8642243898 | ||||||||
| FaxNumber: | 8642243609 | ||||||||
| Practice Location | |||||||||
| Address1: | 7054 VETERANS PKWY | ||||||||
| Address2: | |||||||||
| City: | PELL CITY | ||||||||
| State: | AL | ||||||||
| PostalCode: | 351255117 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8642243898 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 07/11/2012 | ||||||||
| LastUpdateDate: | 01/13/2017 | ||||||||
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| AuthorizedOfficialLastName: | HILLIARD | ||||||||
| AuthorizedOfficialFirstName: | HEYWARD | ||||||||
| AuthorizedOfficialMiddleName: | |||||||||
| AuthorizedOfficialTitleorPosition: | VICE PRESIDENT - OPERATIONS | ||||||||
| AuthorizedOfficialTelephone: | 8642243898 | ||||||||
| IsSoleProprietor: | |||||||||
| IsOrganizationSubpart: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 3336L0003X | 180194 | AL | Y | Suppliers | Pharmacy | Long Term Care Pharmacy |
ID Information
| ID | Type | State | Issuer | Description | 2135835 | 01 | PK | OTHER |