Healthcare Provider Details

I. General information

NPI: 1881812857
Provider Name (Legal Business Name): KLEIN DRUG SHOPPE, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/23/2007
Last Update Date: 05/28/2025
Certification Date: 05/28/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

42794 STATE HIGHWAY 75
ALTOONA AL
35952-6529
US

IV. Provider business mailing address

PO BOX 611
ALTOONA AL
35952-0611
US

V. Phone/Fax

Practice location:
  • Phone: 205-466-3636
  • Fax: 205-466-5511
Mailing address:
  • Phone: 205-466-3636
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code333600000X
TaxonomyPharmacy
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number05390
License Number StateAL

VIII. Authorized Official

Name: ANGIE VAUGHAN
Title or Position: PRESIDENT
Credential:
Phone: 205-466-3636