Healthcare Provider Details

I. General information

NPI: 1003275405
Provider Name (Legal Business Name): C&D PHARMACEUTICALS BERRY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/15/2016
Last Update Date: 02/27/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

31 DEPOT ST
BERRY AL
35546-2086
US

IV. Provider business mailing address

PO BOX 424
BERRY AL
35546-0424
US

V. Phone/Fax

Practice location:
  • Phone: 205-689-4777
  • Fax: 205-689-4778
Mailing address:
  • Phone: 205-689-4777
  • Fax: 205-689-4778

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 Number110447
License Number StateAL

VIII. Authorized Official

Name: CHRISTOPHER CANNON
Title or Position: PHARMACIST/OWNER
Credential:
Phone: 205-689-4777