Provider Demographics
NPI:1356439780
Name:SCOTTSBORO FAMILY PHARMACY, LLC
Entity type:Organization
Organization Name:SCOTTSBORO FAMILY PHARMACY, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JEFFREY
Authorized Official - Middle Name:LEE
Authorized Official - Last Name:HILL
Authorized Official - Suffix:
Authorized Official - Credentials:PHARMD
Authorized Official - Phone:256-259-9300
Mailing Address - Street 1:201 VETERANS DR
Mailing Address - Street 2:SUITE 101
Mailing Address - City:SCOTTSBORO
Mailing Address - State:AL
Mailing Address - Zip Code:35768-2167
Mailing Address - Country:US
Mailing Address - Phone:256-259-9300
Mailing Address - Fax:256-259-9301
Practice Address - Street 1:201 VETERANS DR
Practice Address - Street 2:SUITE 101
Practice Address - City:SCOTTSBORO
Practice Address - State:AL
Practice Address - Zip Code:35768-2167
Practice Address - Country:US
Practice Address - Phone:256-259-9300
Practice Address - Fax:256-259-9301
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-11
Last Update Date:2022-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
332B00000X
AL1126143336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL100003588Medicaid