Provider Demographics
NPI:1447246251
Name:MTM SERVICES OF ALABAMA,INC.
Entity type:Organization
Organization Name:MTM SERVICES OF ALABAMA,INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:REBECCA
Authorized Official - Middle Name:H
Authorized Official - Last Name:STERLING
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:256-518-9530
Mailing Address - Street 1:409 ST CLAIR AVE
Mailing Address - Street 2:
Mailing Address - City:HUNTSVILLE
Mailing Address - State:AL
Mailing Address - Zip Code:35801-5120
Mailing Address - Country:US
Mailing Address - Phone:256-518-9530
Mailing Address - Fax:256-518-9531
Practice Address - Street 1:409 ST CLAIR AVE
Practice Address - Street 2:
Practice Address - City:HUNTSVILLE
Practice Address - State:AL
Practice Address - Zip Code:35801-5120
Practice Address - Country:US
Practice Address - Phone:256-518-9530
Practice Address - Fax:256-518-9531
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-09-27
Last Update Date:2012-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL112821333600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes333600000XSuppliersPharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL529931050Medicaid