Healthcare Provider Details

I. General information

NPI: 1841366481
Provider Name (Legal Business Name): MCCONAGHY DRUG , INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/27/2006
Last Update Date: 11/12/2021
Certification Date: 11/12/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

19390 HWY 43 AND MILDRED STREET
MOUNT VERNON AL
36560
US

IV. Provider business mailing address

PO BOX 160
MOUNT VERNON AL
36560-0160
US

V. Phone/Fax

Practice location:
  • Phone: 251-829-5436
  • Fax: 251-829-6668
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code332BX2000X
TaxonomyOxygen Equipment & Supplies (DME)
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code333600000X
TaxonomyPharmacy
License Number
License Number State
# 4
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number107035
License Number StateAL

VIII. Authorized Official

Name: DAN MCCONAGHY
Title or Position: CFL
Credential: RPH
Phone: 251-675-2070