Provider Demographics
NPI:1982947586
Name:CHRISTOPHER PHARMACY LLC
Entity type:Organization
Organization Name:CHRISTOPHER PHARMACY LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER/SUPERVISING PHARMACIST
Authorized Official - Prefix:DR
Authorized Official - First Name:BENJAMIN
Authorized Official - Middle Name:ROBERT
Authorized Official - Last Name:CHRISTOPHER
Authorized Official - Suffix:
Authorized Official - Credentials:PHARM D
Authorized Official - Phone:251-288-4612
Mailing Address - Street 1:1300 SCHILLINGER RD S STE W2
Mailing Address - Street 2:
Mailing Address - City:MOBILE
Mailing Address - State:AL
Mailing Address - Zip Code:36695-8925
Mailing Address - Country:US
Mailing Address - Phone:251-288-4612
Mailing Address - Fax:251-288-4614
Practice Address - Street 1:1300 SCHILLINGER RD S STE W2
Practice Address - Street 2:
Practice Address - City:MOBILE
Practice Address - State:AL
Practice Address - Zip Code:36695-8925
Practice Address - Country:US
Practice Address - Phone:251-288-4612
Practice Address - Fax:251-288-4614
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-04-02
Last Update Date:2024-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
333600000X
AL1140693336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No333600000XSuppliersPharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
2139601OtherPK
AL148852Medicaid