Healthcare Provider Details

I. General information

NPI: 1912972407
Provider Name (Legal Business Name): J. WATKINS DRUGS, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/20/2006
Last Update Date: 04/05/2022
Certification Date: 04/05/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13286 N WINTZELL AVE
BAYOU LA BATRE AL
36509-2146
US

IV. Provider business mailing address

13286 N WINTZELL AVE
BAYOU LA BATRE AL
36509-2146
US

V. Phone/Fax

Practice location:
  • Phone: 251-824-7455
  • Fax: 251-824-7450
Mailing address:
  • Phone: 251-824-7455
  • Fax: 251-824-7450

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 Number112745
License Number StateAL

VIII. Authorized Official

Name: HEATHER BASS
Title or Position: PHARMACIST/OWNER
Credential:
Phone: 251-824-7455