Michael Ray Macomb, R.PH
Individual provider Active NPI Pharmacist · Montevallo, AL
NPI 1386247252 · NPPES record last updated Nov 20, 2020
Key facts
- NPI
- 1386247252
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Pharmacist 183500000X
- License
- 13187 (AL)
- Practice address
- 700 Main St
Montevallo, AL 35115-3713 - Phone
- (205) 665-1004
- Fax
- (205) 665-1092
- NPI assigned
- Nov 20, 2020
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 2
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
- Credentials
- Registered Pharmacist
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 13187 | AL | MD | Internal Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Alabama CVS Pharmacy, L.L.C. | Past |
Accepting new patients | |
| Alabama CVS Pharmacy LLC | Past |
Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 13187 | AL | Yes |
Addresses
Primary practice location
700 Main St
Montevallo, AL 35115-3713
Mailing address
700 Main St
Montevallo, AL 35115-3713
Phone (205) 665-1004
Other providers in Montevallo, AL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Nov 20, 2020. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.