Madison Pharmacy Inc.

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

114370 Issued in AL

Legal business name

MADISON PHARMACY INC.

Doing business as

Madison Health Mart Pharmacy

Practice address

8498 Madison Blvd Ste a
Madison, AL 35758-2049

Phone

(256) 325-1139

Fax

(256) 325-1159

NPI assigned

Jun 10, 2014

Last updated

May 26, 2022By the provider in NPPES

Organization subpart

Yes

Parent organization

MADISON PHARMACY INC.As reported in NPPES

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

Authorized official

Name

Dr. Seyed Aminoddin Mirramezani, PHARM.D.NPI 1326512864

Title

Chief Operating Officer

Phone

(256) 466-0484

Specialties & licenses 4

Addresses

Other identifiers 1

Other names 1

• Madison Health Mart Pharmacy Doing business as

Medicare fee-for-service enrollment

Enrolled in AL

Enrollment records 1

Tax ID family

Madison Pharmacy Inc2 organizations share this tax ID, including this one

Part of

Madison Pharmacy Inc

Other organizations with this tax ID 1

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

• Madison Pharmacy Inc.

  dba Madison Health Mart Pharmacy

  • Long Term Care Pharmacy
  • Madison, AL
  • NPI 1669110722
  NPD tax ID

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

• Pharmacy of Madison, LLC

  • Community/Retail Pharmacy
  • Madison, AL
  • NPI 1821392366
  NPPES parent name

Practitioners 3

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.

• Seyed Aminoddin Mirramezani

  • Pharmacist
  • Madison, AL
  • NPI 1326512864
  NPD Authorized official
• Kreston Alan Watson, PHARM.D.

  • Pharmacist
  • Huntsville, AL
  • NPI 1518570829
  NPD
• Jillian Allyn Lann, PHARMD

  • Pharmacist
  • Madison, AL
  • NPI 1942801055
  NPD (past)

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

{
    "created_epoch": "1402358400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1653523200000",
    "number": "1588077325",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8498 MADISON BLVD STE A",
            "city": "MADISON",
            "state": "AL",
            "postal_code": "357582049",
            "telephone_number": "256-325-1139",
            "fax_number": "256-325-1159"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8498 MADISON BLVD STE A",
            "city": "MADISON",
            "state": "AL",
            "postal_code": "357582049",
            "telephone_number": "256-325-1139",
            "fax_number": "256-325-1159"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MADISON PHARMACY INC.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "MADISON PHARMACY INC.",
        "enumeration_date": "2014-06-10",
        "last_updated": "2022-05-26",
        "certification_date": "2022-05-26",
        "status": "A",
        "authorized_official_last_name": "MIRRAMEZANI",
        "authorized_official_first_name": "SEYED AMINODDIN",
        "authorized_official_title_or_position": "CHIEF OPERATING OFFICER",
        "authorized_official_telephone_number": "256-466-0484",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PHARM.D."
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "AL",
            "license": "114370",
            "primary": true
        },
        {
            "code": "3336C0004X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Compounding Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336S0011X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Specialty Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2146244",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Madison Health Mart Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Madison Health Mart Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Community/Retail Pharmacy in Madison, AL
• Providers in Madison, AL by specialty
• Community/Retail Pharmacy in Alabama

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 26, 2022; 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.