Healthcare Provider Details
I. General information
NPI: 1003850785
Provider Name (Legal Business Name): ASHLAND PHARMACY, INC.
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 06/15/2006
Last Update Date: 02/09/2024
Certification Date: 02/09/2024
Deactivation Date:
Reactivation Date:
III. Provider practice location address
83074 HIGHWAY 9 83074 HWY 9
ASHLAND AL
36251-7975
US
IV. Provider business mailing address
PO BOX 487
ASHLAND AL
36251-0487
US
V. Phone/Fax
- Phone: 256-354-2166
- Fax: 256-354-2168
- Phone: 256-354-2166
- Fax: 256-354-2168
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 333600000X |
| Taxonomy | Pharmacy |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 3336C0003X |
| Taxonomy | Community/Retail Pharmacy |
| License Number | 101240 |
| License Number State | AL |
VIII. Authorized Official
Name:
PHYLLIS
HUBBARD
Title or Position: BOOKKEEPER
Credential: BOOKKEEPER
Phone: 256-354-2166