Healthcare Provider Details

I. General information

NPI: 1902162548
Provider Name (Legal Business Name): APOTHECARY SALES INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/09/2012
Last Update Date: 02/24/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3220 HIGHWAY 31 S STE A2
DECATUR AL
35603-1731
US

IV. Provider business mailing address

PO BOX 5694
DECATUR AL
35601-0694
US

V. Phone/Fax

Practice location:
  • Phone: 256-340-3700
  • Fax: 256-340-3730
Mailing address:
  • Phone: 256-340-3700
  • Fax: 256-340-3730

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code333600000X
TaxonomyPharmacy
License Number27640
License Number StateTX
# 2
Primary TaxonomyY
Taxonomy Code333600000X
TaxonomyPharmacy
License Number113687
License Number StateAL
# 3
Primary TaxonomyN
Taxonomy Code333600000X
TaxonomyPharmacy
License Number08975/7.1
License Number StateMS
# 4
Primary TaxonomyN
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License NumberPH 25603
License Number StateFL

VIII. Authorized Official

Name: ALMEDA BORDEN
Title or Position: SUPERVISING PHARMACIST
Credential: PHARM D
Phone: 256-340-3700