Healthcare Provider Details

I. General information

NPI: 1225447485
Provider Name (Legal Business Name): BRANNON STAND DRUGS, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/12/2014
Last Update Date: 05/09/2022
Certification Date: 05/09/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1971 S BRANNON STAND RD SUITE 1
DOTHAN AL
36305-7180
US

IV. Provider business mailing address

1971 S BRANNON STAND RD SUITE 1
DOTHAN AL
36305-7180
US

V. Phone/Fax

Practice location:
  • Phone: 334-446-5300
  • Fax: 334-446-3122
Mailing address:
  • Phone: 334-446-5300
  • Fax: 334-446-3122

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code3336L0003X
TaxonomyLong Term Care Pharmacy
License Number
License Number State

VIII. Authorized Official

Name: DR. KEVIN A TAYLOR
Title or Position: SUPERVISING PHARMACIST
Credential: PHARMD
Phone: 850-326-1525