Shady Acres Inc

Primary specialty

Long Term Care PharmacyTaxonomy code 3336L0003X

License

105493 Issued in AL

Legal business name

SHADY ACRES INC

Doing business as

IV Stat Inc

Practice address

302 Prairie St N
Suite 3B
Union Springs, AL 36089-1417

Phone

(334) 738-2022

NPI assigned

Feb 14, 2007

Last updated

Jun 24, 2008By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Benjamin G Main Sr.

Title

MGR

Phone

(334) 750-2103

Specialties & licenses 1

Addresses

Other names 1

• IV STAT INC Doing business as

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

{
    "created_epoch": "1171411200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1214265600000",
    "number": "1881737526",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 432",
            "city": "UNION SPRINGS",
            "state": "AL",
            "postal_code": "360890432",
            "telephone_number": "334-738-2022",
            "fax_number": "334-738-8050"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "302 PRAIRIE ST N",
            "address_2": "SUITE 3B",
            "city": "UNION SPRINGS",
            "state": "AL",
            "postal_code": "360891417",
            "telephone_number": "334-738-2022"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SHADY ACRES INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-14",
        "last_updated": "2008-06-24",
        "status": "A",
        "authorized_official_last_name": "MAIN",
        "authorized_official_first_name": "BENJAMIN",
        "authorized_official_middle_name": "G",
        "authorized_official_title_or_position": "MGR",
        "authorized_official_telephone_number": "334-750-2103",
        "authorized_official_name_suffix": "Sr."
    },
    "taxonomies": [
        {
            "code": "3336L0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Long Term Care Pharmacy",
            "state": "AL",
            "license": "105493",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "IV STAT INC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Long Term Care Pharmacy in Union Springs, AL
• Providers in Union Springs, AL by specialty
• Long Term Care Pharmacy in Alabama

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 24, 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.