Healthcare Provider Details

I. General information

NPI: 1891873147
Provider Name (Legal Business Name): CLOVERLAND DRUGS, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/02/2006
Last Update Date: 06/14/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5350 ATLANTA HWY # C
MONTGOMERY AL
36109-3324
US

IV. Provider business mailing address

5350 ATLANTA HWY # C
MONTGOMERY AL
36109-3324
US

V. Phone/Fax

Practice location:
  • Phone: 334-279-7413
  • Fax: 334-279-7418
Mailing address:
  • Phone: 334-279-7413
  • Fax: 334-279-7418

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number111672
License Number StateAL

VIII. Authorized Official

Name: DAVID GLENN SAALWAECHTER
Title or Position: PRESIDENT/OWNER
Credential:
Phone: 334-279-7413