NPIMap

Organization Active NPI

Medical Park Pharmacy Inc

Doing business as Medical Park Pharmacy

  • Pharmacy
  • Phenix City, AL
National Provider Identifier
1629160841
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacyTaxonomy code 333600000X
License
106743 Issued in AL
Legal business name
MEDICAL PARK PHARMACY INC
Doing business as
Medical Park Pharmacy
Practice address
1623 21St CT
Phenix City, AL 36867
Phone
(334) 298-4010
Fax
(334) 298-0342
NPI assigned
Sep 28, 2006
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Mr. Norman Willard Davis, RPHNPI 1386736502
Title
Pres
Phone
(334) 298-4010

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacy 333600000X 106743 AL Primary

Addresses

Primary practice location

1623 21St CT
Phenix City, AL 36867

Mailing address

1623 21St CT
Phenix City, AL 36867
Phone (334) 298-4010

Other identifiers 2

IdentifierTypeStateIssuer
00176063AMedicaidGA
0114289OtherNABP

Other names 1

  • Medical Park Pharmacy Doing business as

National Provider Directory

National Provider Directory

Locations

1623 21st Ct
Phenix City, AL 36867
Phone (334) 298-4010

Practitioners & affiliated clinicians

Practitioners 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1159401600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1629160841",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1623 21ST CT",
            "city": "PHENIX CITY",
            "state": "AL",
            "postal_code": "36867",
            "telephone_number": "334-298-4010",
            "fax_number": "334-298-0342"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1623 21ST CT",
            "city": "PHENIX CITY",
            "state": "AL",
            "postal_code": "36867",
            "telephone_number": "334-298-4010",
            "fax_number": "334-298-0342"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MEDICAL PARK PHARMACY INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-28",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "DAVIS",
        "authorized_official_first_name": "NORMAN",
        "authorized_official_middle_name": "WILLARD",
        "authorized_official_title_or_position": "PRES",
        "authorized_official_telephone_number": "334-298-4010",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "RPH"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": "AL",
            "license": "106743",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00176063A",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NABP",
            "identifier": "0114289",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Medical Park Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Phenix City, AL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.