Healthcare Provider Details

I. General information

NPI: 1114009784
Provider Name (Legal Business Name): FOSTER DRUG CO., INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/20/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1554 S FOREST AVE
LUVERNE AL
36049-7332
US

IV. Provider business mailing address

1554 S FOREST AVE
LUVERNE AL
36049-7332
US

V. Phone/Fax

Practice location:
  • Phone: 334-335-6553
  • Fax: 334-335-6554
Mailing address:
  • Phone: 334-335-6553
  • Fax: 334-335-6554

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code333600000X
TaxonomyPharmacy
License Number104090
License Number StateAL

VIII. Authorized Official

Name: ALAN FOSTER CARPENTER
Title or Position: SEC/TREAS
Credential: R.PH.
Phone: 334-335-6553