TOTAL LIFE CARE COMPOUNDING (LAKE SIDE PHARMACY) NPI 1093078768

Pharmacy (Community/Retail Pharmacy) in Cedar Bluff, AL

NPI 1093078768 Organization Pharmacy Community/Retail Pharmacy

About TOTAL LIFE CARE COMPOUNDING (LAKE SIDE PHARMACY)

Total Life Care Compounding (lake Side Pharmacy) is a provider established in Cedar Bluff, Alabama specializing in pharmacy (community/retail pharmacy) . The NPI number of Total Life Care Compounding (lake Side Pharmacy) is 1093078768 and was assigned on June 2012. The practitioner's primary taxonomy code is 3336C0003X with license number 113926 (AL). The provider is registered as an organization and their NPI record was last updated 5 years ago. The provider's other name is Total Life Care Compounding. The authorized official of this NPI record is Dr. Stephen Wilson Pharm.d. (Pharmacist In Charge)

NPI

1093078768

Provider NameTOTAL LIFE CARE COMPOUNDING (LAKE SIDE PHARMACY)
Provider Location Address10005 AL HIGHWAY 9 N CEDAR BLUFF, AL 35959
Provider Mailing Address10005 AL HIGHWAY 9 N CEDAR BLUFF, AL 35959
NPI Entity TypeOrganization
Is Sole Proprietor?N/A
Is Organization Subpart?No
Other Organization NameTOTAL LIFE CARE COMPOUNDING
Other Name TypeOther Name (5)
Enumeration Date06-19-2012
Last Update Date01-03-2017


Primary Taxonomy

Taxonomy Code3336C0003X
ClassificationPharmacy
TypeSuppliers
SpecializationCommunity/Retail Pharmacy
License No.113926
License StateAL
Taxonomy DescriptionA pharmacy where pharmacists store, prepare, and dispense medicinal preparations and/or prescriptions for a local patient population in accordance with federal and state law; counsel patients and caregivers (sometimes independent of the dispensing process); administer vaccinations; and provide other professional services associated with pharmaceutical care such as health screenings, consultative services with other health care providers, collaborative practice, disease state management, and education classes.

Business Address

TOTAL LIFE CARE COMPOUNDING
10005 AL HIGHWAY 9 N
CEDAR BLUFF, AL
ZIP 35959
Phone: (844) 236-5360
Fax: (866) 609-4582

Get Directions


Mailing Address

TOTAL LIFE CARE COMPOUNDING
10005 AL HIGHWAY 9 N
CEDAR BLUFF, AL
ZIP 35959
Phone: (844) 236-5360
Fax: (866) 609-4582



Authorized Official

Authorized Official NameDR. STEPHEN WILSON PHARM.D.
Authorized Official TitlePHARMACIST IN CHARGE
Authorized Official Phone(844) 236-5360

Additional Identifiers


Additional identifier(s) currently or formerly used as an identifier for the provider. The codes may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.

Identifier Type / Code Identifier State
113926OTHER (01)AL

Other Providers at the same location


The following provider is registered at the same or nearby location.

NPI Name / Type Taxonomy Address
1750736963 STEPHEN WILSON PHARM.D.
Individual
Pharmacist10005 AL HIGHWAY 9 N
CEDAR BLUFF, AL 35959
(256) 422-5010

NPI Footnotes

What is the National Provider Indentifier (NPI)?
The NPI is 10-position all-numeric identification number assigned by the NPPES to uniquely identify a health care provider.

Provider Location Address
The location address of the provider being identified. For providers with more than one physical location, this is the primary location. This address cannot include a Post Office box.

Provider Mailing Address
The mailing address of the provider being identified. This address may contain the same information as the provider location address.

Entity Type Code
The code describing the type of health care provider that is being assigned an NPI.
The entity type codes are:
1 = Person: individual human being who furnishes health care;
2 = Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)

What is a Subpart?
Subparts are the components and separate physical locations of organization health care providers. Subpart examples include:
Hospital components include outpatient departments, surgical centers, psychiatric units, and laboratories. These components are often separately licensed or certified by States and may exist at physical locations other than that of the hospital of which they are a component.

Provider Other Organization Name
The other organization name is the alternative last name by which the provider is or has been known (if an individual) or other name by which the organization provider is or has been known. The code identifying the type of other name. The provider other organization name codes are:
1 = former name;
2 = professional name;
3 = doing business as (d/b/ a) name;
4 = former legal business name; :
5 = other.

Provider Enumeration Date
The date the provider was assigned a unique identifier (assigned an NPI).

Last Update Date
The date that a NPI record was last updated or changed.

Primary Taxonomy Code
The primary taxonomy code defines the provider type, classification, and specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.

Authorized Official Name
The name of the person authorized to submit the NPI application or to officially change data for a health care provider.