Healthcare Provider Details

I. General information

NPI: 1003228701
Provider Name (Legal Business Name): DAWES FAMILY PHARMACY, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/29/2014
Last Update Date: 10/18/2024
Certification Date: 10/18/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8650 COTTAGE HILL RD SUITE 101
MOBILE AL
36695-3612
US

IV. Provider business mailing address

PO BOX 129
GRAND BAY AL
36541-0129
US

V. Phone/Fax

Practice location:
  • Phone: 251-607-9800
  • Fax: 251-607-9977
Mailing address:
  • Phone: 251-865-1040
  • Fax: 251-865-1041

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code333600000X
TaxonomyPharmacy
License Number114360
License Number StateAL
# 2
Primary TaxonomyN
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number
License Number State

VIII. Authorized Official

Name: MR. CHARLES DANIEL COTTRELL
Title or Position: PRESIDENT
Credential: R.PH
Phone: 251-607-9800