Healthcare Provider Details

I. General information

NPI: 1104864669
Provider Name (Legal Business Name): CURTIS M EDDY INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/04/2006
Last Update Date: 12/10/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2200 VILLAGE DR
MOODY AL
35004-3241
US

IV. Provider business mailing address

PO BOX 787
ODENVILLE AL
35120-0787
US

V. Phone/Fax

Practice location:
  • Phone: 205-640-1500
  • Fax: 205-640-5525
Mailing address:
  • Phone: 205-629-6303
  • Fax: 205-629-7450

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code333600000X
TaxonomyPharmacy
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number112732
License Number StateAL

VIII. Authorized Official

Name: CURTIS EDDY
Title or Position: OWNER PHARMACIST
Credential: PHARM D
Phone: 205-640-1500