Healthcare Provider Details

I. General information

NPI: 1366509051
Provider Name (Legal Business Name): BYNUM DRUG INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/02/2007
Last Update Date: 04/25/2022
Certification Date: 04/25/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8749 AL HIGHWAY 202
EASTABOGA AL
36260
US

IV. Provider business mailing address

PO BOX 368
BYNUM AL
36253
US

V. Phone/Fax

Practice location:
  • Phone: 256-237-7533
  • Fax: 256-237-7537
Mailing address:
  • Phone: 256-237-7533
  • Fax: 256-237-7537

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code333600000X
TaxonomyPharmacy
License Number102005
License Number StateAL

VIII. Authorized Official

Name: MS. AMANDA K. GUINN
Title or Position: PHARMACIST
Credential: PHARMACIST
Phone: 256-237-7533