Unknown Individual – Pharmacist, NPI 1114924636

Unknown Individual is a healthcare provider. based in Birmingham, Alabama. specializing in Pharmacist. They hold a License No. 6324 (AL). The NPI Number for Unknown Individual is 1114924636

Main info

Organization
Inactive
Name
Unknown Individual
NPI
1114924636
Phone
(205) 942-1308
Address
1859 LAKE RIDGE RD
Deactivation Date
13 October 2023
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience14
Completeness75
Years active:0State licenses:1Digital endpointsOther names

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Provider Addresses for Unknown Individual

  • Ridge Road, Roebuck Springs, Birmingham, Jefferson County, Alabama, 35206, United States

    BIRMINGHAM, AL 352161619

    Phone: (205) 942-1308

    Fax: (205) 942-4539

    Type: Mailing

  • Sharp Carpet, 320, Oxmoor Road, Edgemont, Homewood, Jefferson County, Alabama, 35209, United States

    HOMEWOOD, AL 352096116

    Phone: (205) 942-4661

    Fax: (205) 942-4539

    Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

No Medicare enrollment or revalidation data available for this provider in our database.

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 35216)

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Reviews

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Frequently asked questions

How do payers reference Unknown Individual?
For Unknown Individual, use NPI 1114924636 as the unique 10-digit identifier.
Is inactive the same as retired for Unknown Individual?
Inactive registry status can reflect deactivation, consolidation, or data lag.
What clinical focus is listed for Unknown Individual?
At a glance, Unknown Individual is tied to Pharmacist. Clinical services aligned with this taxonomy classification.
What practice footprint exists for Unknown Individual?
Travel planning: use Birmingham, Alabama as the reference point for Unknown Individual, then confirm.
Does inactive status remove historical data?
Historical rows can remain visible after status changes — read the dates carefully.

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