Active NPI
SRX LLC
Doing business as Royal Street Pharmacy
- Community/Retail Pharmacy
- Mobile, AL
National Provider Identifier
1023512829
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Community/Retail Pharmacy
- License
- 114788
- Legal business name
- SRX LLC
- Doing business as
- Royal Street Pharmacy
- Practice address
- 1 S Royal St
Mobile, AL 36602-3234 - Phone
- (251) 277-8990
- Fax
- (251) 517-4441
- NPI assigned
- Mar 19, 2018
- Last updated
- Nov 28, 2023
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Kelly H Stinson
- Title
- President/Pharmacist
- Phone
- (251) 277-8990
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacy | 333600000X | NU | ||
| Community/Retail Pharmacy | 3336C0003X | 114788 | AL | Primary |
Addresses
Primary practice location
1 S Royal St
Mobile, AL 36602-3234
Mailing address
1 S Royal St
Mobile, AL 36602-3234
Phone (251) 277-8990
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 218146 | Medicaid | AL | |
| 2177901 | Other | PK |
Other names 2
- Royal Street Pharmacy
- JKLD II LLC
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in AL
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20240326000978 | AL | Part B Supplier - Mass Immunization (Roster Biller Only) | 3577900596 |
2 other NPIs on this enrollment This NPI is an additional NPI on the enrollment Practice locations: Mobile, AL; Saraland, AL |
Other NPIs on the same Medicare enrollment 2
NPIs listed together on one Medicare enrollment, typically parts of the same organization.
National Provider Directory
National Provider Directory- Tax ID family
- JKLD II LLC
Other organizations with this tax ID 2
Organizations that report the same tax identification number in the National Provider Directory.
Locations
1 S Royal St
Mobile, AL 36602
Phone (251) 277-8990
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1521417600000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1701129600000",
"number": "1023512829",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1 S ROYAL ST",
"city": "MOBILE",
"state": "AL",
"postal_code": "366023234",
"telephone_number": "251-277-8990",
"fax_number": "251-517-4441"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1 S ROYAL ST",
"city": "MOBILE",
"state": "AL",
"postal_code": "366023234",
"telephone_number": "251-277-8990",
"fax_number": "251-517-4441"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "SRX LLC",
"organizational_subpart": "NO",
"enumeration_date": "2018-03-19",
"last_updated": "2023-11-28",
"certification_date": "2023-11-28",
"status": "A",
"authorized_official_last_name": "STINSON",
"authorized_official_first_name": "KELLY",
"authorized_official_middle_name": "H",
"authorized_official_title_or_position": "PRESIDENT/PHARMACIST",
"authorized_official_telephone_number": "251-277-8990"
},
"taxonomies": [
{
"code": "333600000X",
"taxonomy_group": "",
"desc": "Pharmacy",
"state": "NU",
"license": null,
"primary": false
},
{
"code": "3336C0003X",
"taxonomy_group": "",
"desc": "Pharmacy, Community/Retail Pharmacy",
"state": "AL",
"license": "114788",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "218146",
"state": "AL"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PK",
"identifier": "2177901",
"state": null
}
],
"endpoints": [],
"other_names": [
{
"organization_name": "Royal Street Pharmacy",
"code": "3",
"type": "Doing Business As"
},
{
"organization_name": "Royal Street Pharmacy",
"code": "3",
"type": "Doing Business As"
},
{
"organization_name": "JKLD II LLC",
"code": "4",
"type": "Former Legal Business Name"
}
]
}Other providers in Mobile, AL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 28, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.