Healthcare Provider Details

I. General information

NPI: 1588674170
Provider Name (Legal Business Name): PEOPLES DRUGS & VARIETY,INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/08/2006
Last Update Date: 06/25/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8260 HIGHWAY 72
CHEROKEE AL
35616-4402
US

IV. Provider business mailing address

8260 HIGHWAY 72 PO BOX J
CHEROKEE AL
35616-4402
US

V. Phone/Fax

Practice location:
  • Phone: 256-359-6242
  • Fax: 256-359-4652
Mailing address:
  • Phone: 256-359-6242
  • Fax: 256-359-4652

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number107670
License Number StateAL

VIII. Authorized Official

Name: MS. TRACY CHESTEEN WIX
Title or Position: OWNER-PRESIDENT
Credential: RPH
Phone: 256-359-6242