Healthcare Provider Details

I. General information

NPI: 1720078447
Provider Name (Legal Business Name): GADSDEN PHARMACY LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/25/2005
Last Update Date: 10/04/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

911 RAINBOW DR
GADSDEN AL
35901-5309
US

IV. Provider business mailing address

911 RAINBOW DR
GADSDEN AL
35901-5309
US

V. Phone/Fax

Practice location:
  • Phone: 256-547-4479
  • Fax: 256-549-0577
Mailing address:
  • Phone: 256-547-4479
  • Fax: 256-549-0577

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number
License Number State

VIII. Authorized Official

Name: MRS. MELISSA ANN LESLIE
Title or Position: PHARMACIST OWNER
Credential: RPH
Phone: 256-547-4479