NPIMap

Organization Active NPI

Senior Care Pharmacy Inc

  • Long Term Care Pharmacy
  • Northport, AL
National Provider Identifier
1346239795
Registry record updated Jul 17, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Long Term Care PharmacyTaxonomy code 3336L0003X
License
113151 Issued in AL
Legal business name
SENIOR CARE PHARMACY INC
Practice address
4373 Northcreek Blvd
Northport, AL 35473-2171
Phone
(205) 391-3636
Fax
(866) 680-7046
NPI assigned
Oct 18, 2005
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 17, 2024

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

Authorized official

Name
Phillip Cody Long
Title
Chief Financial Officer
Phone
(205) 391-3600

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacy 333600000X
Long Term Care Pharmacy 3336L0003X 113151 AL Primary

Addresses

Primary practice location

4373 Northcreek Blvd
Northport, AL 35473-2171

Mailing address

4373 Northcreek Blvd
Northport, AL 35473-2171
Phone (205) 391-3636

Other identifiers 2

IdentifierTypeStateIssuer
100001796MedicaidAL
1990860OtherPK

Other names 1

  • SENIOR CARE PHARMACY, INC Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20201118002050 AL Part B Supplier - Mass Immunization (Roster Biller Only) 6901217272 2 other NPIs on this enrollment
Practice locations: Northport, AL; Daphne, AL; Irondale, 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
Senior Care Pharmacy Inc3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

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

Ownership & related parties

Subparts reporting this organization as parent 2

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

NPI Registry JSON

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

{
    "created_epoch": "1129593600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1721174400000",
    "number": "1346239795",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4373 NORTHCREEK BLVD",
            "city": "NORTHPORT",
            "state": "AL",
            "postal_code": "354732171",
            "telephone_number": "205-391-3636",
            "fax_number": "866-680-7046"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4373 NORTHCREEK BLVD",
            "city": "NORTHPORT",
            "state": "AL",
            "postal_code": "354732171",
            "telephone_number": "205-391-3636",
            "fax_number": "866-680-7046"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SENIOR CARE PHARMACY INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-10-18",
        "last_updated": "2024-07-17",
        "certification_date": "2024-07-17",
        "status": "A",
        "authorized_official_last_name": "LONG",
        "authorized_official_first_name": "PHILLIP",
        "authorized_official_middle_name": "CODY",
        "authorized_official_title_or_position": "CHIEF FINANCIAL OFFICER",
        "authorized_official_telephone_number": "205-391-3600"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336L0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Long Term Care Pharmacy",
            "state": "AL",
            "license": "113151",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100001796",
            "state": "AL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "1990860",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "SENIOR CARE PHARMACY, INC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Northport, AL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 17, 2024; 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.

Verify at the official NPI Registry.