CHOICE SOURCE THERAPEUTIC SOUTH LLC (NPI# 1720069628) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1720069628 |
| Entity Type | Organization |
| Organization Name | CHOICE SOURCE THERAPEUTIC SOUTH LLC |
| Practice Address |
1048 Stanton Rd Suite A Daphne AL 36526-4294 |
| Mailing Address |
Department 6175 Los Angeles CA 90088-6175 |
| Practice Telephone | 2516215300 |
| Practice Fax Number | 2516215318 |
| Mailing Telephone | 8002255967 |
| Mailing Fax Number | 9097994364 |
| Enumeration Date | 2005-11-08 |
| Last Update Date | 2007-08-20 |
| Authorized Official Name | MR. DAVID WILLIAM BORDER (AUTHORIZED SIGNER) |
| Authorized Official Telephone | 8002255967 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 332B00000X | Durable Medical Equipment & Medical Supplies | 112079 | AL | Suppliers |
| N | 333600000X | Pharmacy | 112079 | AL | Suppliers |
| Y | 3336S0011X |
Pharmacy Specialization: Specialty Pharmacy |
Suppliers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MS | 0330543 | 05 |
| Street Address |
1048 STANTON RD SUITE A |
| City | DAPHNE |
| State | AL |
| Zip Code | 36526-4294 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1427595149 | Middle Bay Ventures LLC | Case Management | 1048 Stanton Rd, Suite D, Daphne, AL 36526-4294 | 2017-01-20 |
| 1134526320 | Middle Bay Ventures LLC - | In Home Supportive Care | 1048 Stanton Rd, Suite D, Daphne, AL 36526-4294 | 2014-12-03 |
| 1861600199 | Gwen Cheryl Zimmerly | Counselor | 1048 Stanton Rd, Suite F, Daphne, AL 36526-4294 | 2007-05-18 |
| 1215143490 | Compound Pharmaceutical Technologies, Inc. | Pharmacy | 1048 Stanton Rd, Suite B, Daphne, AL 36526-4294 | 2007-05-15 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1578173464 | H3o Living, LLC | Clinic/Center | 29000 U.S. 98, Daphne, AL 36526 | 2020-08-05 |
| 1790345403 | Gregory Conner Reese | Student in an Organized Health Care Education/Training Program | 27654 Red Eagle Drive, Daphne, AL 36526 | 2019-06-14 |
| 1649787912 | Jubilee Family Dentistry, LLC | Dentist | 6475 Jordan Avenue, Daphne, AL 36526 | 2018-01-08 |
| 1770090607 | Gary Andrew Gould | Physician Assistant | 28490 2nd St Ste B, Daphne, AL 36526 | 2017-12-31 |
| 1366957011 | Emily Jane Tisdale | Behavioral Analyst | 1203 Us Highway 98 Ste 2a9, Daphne, AL 36526 | 2017-12-04 |
| 1437680600 | Blair Hoffman Pringle | Nurse Practitioner | 26179 Capitol Drive Suite A, Daphne, AL 36526 | 2017-03-21 |
| 1275915324 | Simara Sokom | Pharmacist | 29487 State Highway 181, Daphne, AL 36526 | 2015-06-25 |
| 1366859126 | Seth Matthew Gross | Pharmacist | 101b Villa Drive, Suite B-260, Daphne, AL 36526 | 2014-07-14 |
| 1841627940 | Michelle Renae Counts | Counselor | 9086 Merritt Road Suite C, Williamsburg Plaza, Daphne, AL 36526 | 2013-10-03 |
| 1194066613 | Ryan Nobles | Chiropractor | 6483 Van Buren Street, Suite 101, Daphne, AL 36526 | 2013-03-07 |
| Find all providers in zip 36526 | ||||
| Taxonomy Code | 3336S0011X |
| Grouping | Suppliers |
| Classification | Pharmacy |
| Specialization | Specialty Pharmacy |
| A pharmacy that dispenses generally low volume and high cost medicinal preparations to patients who are undergoing intensive therapies for illnesses that are generally chronic, complex and potentially life threatening. Often these therapies require specialized delivery and administration. |
| Notes: Source: Developed by National Council for Prescription Drug Programs (NCPDP), National Home Infusion Association (NHIA), and Pharmacist Services Technical Advisory Coalition (PSTAC) [1/1/2006: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1043862931 | Pharmacy Center South LLC | Pharmacy | 2826 Ross Clark Circle, Suite 103, Dothan, AL 36301 | 2019-07-11 |
| 1487117982 | East Alabama Apothecary LLC | Pharmacy | 665 Opelika Roade, Suite 400, Auburn, AL 36830 | 2019-04-11 |
| 1598232654 | Starmark Partners Inc | Pharmacy | 165 Chestnut Dr Ste B, Madison, AL 35758-9525 | 2018-10-26 |
| 1922451020 | Covenant Specialty Therapeutics, Inc | Pharmacy | 1707 Hillyer Robinson Industrial Pkwy S, Suite B, Oxford, AL 36203-1373 | 2016-07-13 |
| 1154712685 | K L Arnold Enterprises Inc | Pharmacy | 1726 Cherokee Ave Sw Ste A, Cullman, AL 35055-5383 | 2015-02-05 |
| 1801089875 | Hemophilia Infusion Managers LLC | Pharmacy | 3142 1st Ave, Loxley, AL 36551-4569 | 2007-08-23 |
| 1902931561 | Bishops Scant City Pharmacy & Gifts Inc | Pharmacy | 8095 Al Highway 69, Guntersville, AL 35976-7140 | 2007-02-23 |
| 1700938974 | Auburn University | Pharmacy | 2150 Walker Building, Auburn, AL 36849-5501 | 2007-01-17 |
| 1902961618 | Freeman Pharmacy, Inc. | Pharmacy | 209 W Mlk Hwy, Suite D, Tuskegee, AL 36083-2104 | 2006-12-22 |
| 1194810036 | Huntsville Compounding Pharmacy Inc | Pharmacy | 2121 Whitesburg Dr Se, Ste E, Huntsville, AL 35801-4501 | 2006-10-04 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.