Moundville Medical Plaza Inc.

Primary specialty

PharmacistTaxonomy code 183500000X

Legal business name

MOUNDVILLE MEDICAL PLAZA INC.

Practice address

16061 Hwy 69 South
Moundville, AL 35474

Phone

(205) 371-9031

Fax

(205) 371-9074

NPI assigned

Mar 20, 2007

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mr. Clifford Allen Harland Jr.

Title

President

Phone

(205) 371-9031

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1174348800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1213574400000",
    "number": "1013032648",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16061 HWY 69 SOUTH",
            "address_2": "P.O. BOX 551",
            "city": "MOUNDVILLE",
            "state": "AL",
            "postal_code": "35474",
            "telephone_number": "205-371-9031",
            "fax_number": "205-371-9074"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16061 HWY 69 SOUTH",
            "city": "MOUNDVILLE",
            "state": "AL",
            "postal_code": "35474",
            "telephone_number": "205-371-9031",
            "fax_number": "205-371-9074"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MOUNDVILLE MEDICAL PLAZA INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-20",
        "last_updated": "2008-06-16",
        "status": "A",
        "authorized_official_last_name": "HARLAND",
        "authorized_official_first_name": "CLIFFORD",
        "authorized_official_middle_name": "ALLEN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "205-371-9031",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_name_suffix": "Jr."
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pharmacist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100001507",
            "state": "AL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Pharmacist in Moundville, AL
• Providers in Moundville, AL by specialty
• Pharmacist in Alabama

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 16, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.