Medaus Pharmacy and Compounding Center

Primary specialty

Compounding PharmacyTaxonomy code 3336C0004X

License

111215 Issued in AL

Legal business name

MEDAUS PHARMACY AND COMPOUNDING CENTER

Practice address

6801 Cahaba Valley Rd Ste 116
Birmingham, AL 35242-9609

Phone

(205) 981-2352

Fax

(205) 981-2767

NPI assigned

Oct 9, 2006

Last updated

Aug 8, 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

Mr. Larry Don Stephens, R. PH.

Title

C.O.O.

Phone

(205) 981-2352

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1160352000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1218153600000",
    "number": "1932296183",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6801 CAHABA VALLEY RD STE 116",
            "city": "BIRMINGHAM",
            "state": "AL",
            "postal_code": "352429609",
            "telephone_number": "205-981-2352",
            "fax_number": "205-981-2767"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6801 CAHABA VALLEY RD STE 116",
            "city": "BIRMINGHAM",
            "state": "AL",
            "postal_code": "352429609",
            "telephone_number": "205-981-2352",
            "fax_number": "205-981-2767"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MEDAUS PHARMACY AND COMPOUNDING CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-09",
        "last_updated": "2008-08-08",
        "status": "A",
        "authorized_official_last_name": "STEPHENS",
        "authorized_official_first_name": "LARRY",
        "authorized_official_middle_name": "DON",
        "authorized_official_title_or_position": "C.O.O.",
        "authorized_official_telephone_number": "205-981-2352",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "R. PH."
    },
    "taxonomies": [
        {
            "code": "3336C0004X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Compounding Pharmacy",
            "state": "AL",
            "license": "111215",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NCPDP",
            "identifier": "0128149",
            "state": "AL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Compounding Pharmacy in Alabama

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 8, 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.