| Organization Name: | MIKES PHARMACY OF HEADLAND INC |
| NPI Number: | 1952773814 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | MICHAEL PITZING (OWNER) |
| Mailing Address: | 202 Holman Dr Headland |
| State: | AL US |
| Postal Code: | 363452307 |
| Phone Number: | 3346933324 |
| Fax Number: | 3346935051 |
| NPI Enumeration Date: | 10/30/2015 |
| NPI Last Update Date: | 06/09/2016 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 332BP3500X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | |
| Taxonomy Type: | Suppliers |
| Taxonomy Classification: | Durable Medical Equipment & Medical Supplies |
| Taxonomy Specialization: | Parenteral & Enteral Nutrition |
| Taxonomy Definition: | |