Healthcare Provider Details

I. General information

NPI: 1043227044
Provider Name (Legal Business Name): LINCOLN PHARMACY INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/02/2006
Last Update Date: 02/15/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

99 MAGNOLIA ST S
LINCOLN AL
35096-0200
US

IV. Provider business mailing address

102 JD SMITH DR ALACO WAREHOUSE BUSINESS OFFICE
ATTALLA AL
35954-3350
US

V. Phone/Fax

Practice location:
  • Phone: 205-763-7759
  • Fax: 205-763-2131
Mailing address:
  • Phone: 256-538-5697
  • Fax: 256-538-0239

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code333600000X
TaxonomyPharmacy
License Number111394
License Number StateAL

VIII. Authorized Official

Name: MR. RON A STRICKLAND
Title or Position: PRESIDENT
Credential: RPH
Phone: 205-763-7759