NPIMap

Organization Active NPI

Southeast Alabama Medical Center Employee Pharmacy

  • Pharmacy
  • Dothan, AL
National Provider Identifier
1053526368
Registry record updated Sep 25, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacyTaxonomy code 333600000X
License
113196 Issued in AL
Legal business name
SOUTHEAST ALABAMA MEDICAL CENTER EMPLOYEE PHARMACY
Practice address
1108 Ross Clark Cir
Dothan, AL 36301-3001
Phone
(334) 793-8113
Fax
(334) 712-3701
NPI assigned
May 11, 2007
Last updated
Sep 25, 2013By the provider in NPPES
Organization subpart
Yes
Parent organization
HOUSTON COUNTY HEALTH CARE AUTHORITYAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Sep 25, 2013

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

Authorized official

Name
Robert Derek Miller
Title
Cfo
Phone
(334) 793-8701

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacy 333600000X 150080 AL
Pharmacy 333600000X 113196 AL Primary

Addresses

Primary practice location

1108 Ross Clark Cir
Dothan, AL 36301-3001

Mailing address

PO Box 6987
Dothan, AL 36305-6987
Phone (334) 793-8113

National Provider Directory

National Provider Directory
Tax ID family
Southeast Alabama Med C17 organizations share this tax ID, including this one
Part of
Southeast Alabama Med C

Other organizations with this tax ID 16

Organizations that report the same tax identification number in the National Provider Directory.

View all 16

Practitioners & affiliated clinicians

Practitioners 87

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 87

NPI Registry JSON

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

{
    "created_epoch": "1178841600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1380067200000",
    "number": "1053526368",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 6987",
            "city": "DOTHAN",
            "state": "AL",
            "postal_code": "363056987",
            "telephone_number": "334-793-8113",
            "fax_number": "334-712-3701"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1108 ROSS CLARK CIR",
            "city": "DOTHAN",
            "state": "AL",
            "postal_code": "363013001",
            "telephone_number": "334-793-8113",
            "fax_number": "334-712-3701"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTHEAST ALABAMA MEDICAL CENTER EMPLOYEE PHARMACY",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "HOUSTON COUNTY HEALTH CARE AUTHORITY",
        "enumeration_date": "2007-05-11",
        "last_updated": "2013-09-25",
        "status": "A",
        "authorized_official_last_name": "MILLER",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_middle_name": "DEREK",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "334-793-8701"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": "AL",
            "license": "150080",
            "primary": false
        },
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": "AL",
            "license": "113196",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dothan, AL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 25, 2013; 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.