Healthcare Provider Details

I. General information

NPI: 1487768479
Provider Name (Legal Business Name): WILLIAM AND MARY PHARMACY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/18/2006
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1351 DECATUR HWY STE 115
FULTONDALE AL
35068-1750
US

IV. Provider business mailing address

1351 DECATUR HWY STE 115
FULTONDALE AL
35068-1750
US

V. Phone/Fax

Practice location:
  • Phone: 205-631-5506
  • Fax: 205-631-5536
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code333600000X
TaxonomyPharmacy
License Number112044
License Number StateAL
# 2
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number
License Number State

VIII. Authorized Official

Name: BILLY EAST
Title or Position: PHARMCIST
Credential:
Phone: 205-849-5506