Active NPI
Triad of Alabama LLC
- Pharmacy
- Dothan, AL
National Provider Identifier
1407890106
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacy
- Legal business name
- TRIAD OF ALABAMA LLC
- Practice address
- 119 S Woodburn Dr
Suite 2
Dothan, AL 36305-1050 - Phone
- (334) 793-9674
- NPI assigned
- Jun 15, 2006
- Organization subpart
- Yes
- Parent organization
- TRIAD OF ALABAMA LLC
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Debbie Brewer
- Title
- Director, Provider Enrollment
- Phone
- (615) 465-7626
Specialties & licenses 4
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Durable Medical Equipment & Medical Supplies | 332B00000X | |||
| Pharmacy | 333600000X | Primary | ||
| Home Infusion Therapy Pharmacy | 3336H0001X | |||
| Specialty Pharmacy | 3336S0011X |
Addresses
Primary practice location
119 S Woodburn Dr
Suite 2
Dothan, AL 36305-1050
Mailing address
PO Box 1964
Dothan, AL 36302-1964
Phone (334) 793-9674
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 100003547 | Medicaid | AL |
Other names 1
- Breathing Care - Dothan Pharmacy
National Provider Directory
National Provider Directory- Tax ID family
- Triad of Alabama LLC
- Part of
- Triad of Alabama LLC
Other organizations with this tax ID 1
Organizations that report the same tax identification number in the National Provider Directory.
-
- Diagnostic Radiology Physician
- Dothan, AL
- NPI 1003791658
Locations
119 S Woodburn Dr
Ste 2
Dothan, AL 36305
Phone (334) 793-9674
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1150329600000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1239667200000",
"number": "1407890106",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 1964",
"city": "DOTHAN",
"state": "AL",
"postal_code": "363021964",
"telephone_number": "334-793-9674"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "119 S WOODBURN DR",
"address_2": "SUITE 2",
"city": "DOTHAN",
"state": "AL",
"postal_code": "363051050",
"telephone_number": "334-793-9674"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "TRIAD OF ALABAMA LLC",
"organizational_subpart": "YES",
"parent_organization_legal_business_name": "TRIAD OF ALABAMA LLC",
"enumeration_date": "2006-06-15",
"last_updated": "2009-04-14",
"status": "A",
"authorized_official_last_name": "BREWER",
"authorized_official_first_name": "DEBBIE",
"authorized_official_title_or_position": "DIRECTOR, PROVIDER ENROLLMENT",
"authorized_official_telephone_number": "615-465-7626"
},
"taxonomies": [
{
"code": "332B00000X",
"taxonomy_group": "",
"desc": "Durable Medical Equipment & Medical Supplies",
"state": null,
"license": null,
"primary": false
},
{
"code": "333600000X",
"taxonomy_group": "",
"desc": "Pharmacy",
"state": null,
"license": null,
"primary": true
},
{
"code": "3336H0001X",
"taxonomy_group": "",
"desc": "Pharmacy, Home Infusion Therapy Pharmacy",
"state": null,
"license": null,
"primary": false
},
{
"code": "3336S0011X",
"taxonomy_group": "",
"desc": "Pharmacy, Specialty Pharmacy",
"state": null,
"license": null,
"primary": false
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "100003547",
"state": "AL"
}
],
"endpoints": [],
"other_names": [
{
"organization_name": "Breathing Care - Dothan Pharmacy",
"code": "3",
"type": "Doing Business As"
}
]
}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 Apr 14, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.