Healthcare Provider Details

I. General information

NPI: 1437125994
Provider Name (Legal Business Name): EILAND INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/24/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

139 E BROAD ST
EUFAULA AL
36027-2023
US

IV. Provider business mailing address

139 E BROAD ST
EUFAULA AL
36027-2023
US

V. Phone/Fax

Practice location:
  • Phone: 334-687-2061
  • Fax: 334-687-2062
Mailing address:
  • Phone: 334-687-2061
  • Fax: 334-687-2062

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code333600000X
TaxonomyPharmacy
License Number108710
License Number StateAL

VIII. Authorized Official

Name: MR. CARLOS M EILAND
Title or Position: OWNER/PHARMACIST
Credential:
Phone: 334-687-2061