Healthcare Provider Details
I. General information
NPI: 1033032826
Provider Name (Legal Business Name): BOONE PHARMACY MANAGEMENT, INC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 07/30/2026
Last Update Date: 07/30/2026
Certification Date: 07/30/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
201 COMMERCE ST
JACKSON AL
36545-2717
US
IV. Provider business mailing address
PO BOX 426
JACKSON AL
36545-0426
US
V. Phone/Fax
- Phone: 251-246-3616
- Fax: 251-246-2277
- Phone: 251-246-3616
- Fax: 251-246-2277
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 3336L0003X |
| Taxonomy | Long Term Care Pharmacy |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
RICHARD
LAMAR
BOONE
Title or Position: PRESIDENT
Credential: RPH
Phone: 334-341-3466