Medical Center Pharmacy

Primary specialty

PharmacistTaxonomy code 183500000X

License

106725 Issued in AL

Legal business name

MEDICAL CENTER PHARMACY

Practice address

609 Gandy St NE
Russellville, AL 35653

Phone

(256) 331-9060

Fax

(256) 332-4210

NPI assigned

Mar 22, 2006

Organization subpart

No

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

Authorized official

Name

Mr. Jimmy Greg Lane, RPH

Title

Owner RPH

Phone

(256) 332-4021

Specialties & licenses 1

Addresses

Other identifiers 2

Locations

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

{
    "created_epoch": "1142985600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1215043200000",
    "number": "1447219936",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "609 GANDY ST NE",
            "city": "RUSSELLVILLE",
            "state": "AL",
            "postal_code": "35653",
            "telephone_number": "256-331-9060",
            "fax_number": "256-332-4210"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "609 GANDY ST NE",
            "city": "RUSSELLVILLE",
            "state": "AL",
            "postal_code": "35653",
            "telephone_number": "256-331-9060",
            "fax_number": "256-332-4210"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MEDICAL CENTER PHARMACY",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-03-22",
        "last_updated": "2008-07-03",
        "status": "A",
        "authorized_official_last_name": "LANE",
        "authorized_official_first_name": "JIMMY",
        "authorized_official_middle_name": "GREG",
        "authorized_official_title_or_position": "OWNER RPH",
        "authorized_official_telephone_number": "256-332-4021",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "RPH"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Pharmacist",
            "state": "AL",
            "license": "106725",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NCPDP",
            "identifier": "0123935",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100002480",
            "state": "AL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jordan Nicole Reynolds Mayfield, COTA/L
• Wesley Charles Mayfield
• David W McGee, OD
• Medexpress Littleville LLC
• Medexpress Littleville LLC
• Michael a McCormick DO PC
• Bryan Miller
• Alyssa W Minshew
• Mission Medical, Inc
• Jo Anna Lea Monroe, CRNP

• Pharmacist in Russellville, AL
• Providers in Russellville, AL by specialty
• Pharmacist in Alabama

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 3, 2008; 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.