Healthcare Provider Details

I. General information

NPI: 1245320613
Provider Name (Legal Business Name): PHIL CAMPBELL DRUGS, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/13/2006
Last Update Date: 12/06/2023
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2936 HIGHWAY 237
PHIL CAMPBELL AL
35581
US

IV. Provider business mailing address

PO BOX 610
PHIL CAMPBELL AL
35581-0610
US

V. Phone/Fax

Practice location:
  • Phone: 205-993-4123
  • Fax: 205-993-5181
Mailing address:
  • Phone: 205-993-4123
  • Fax: 205-993-5181

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number107705
License Number StateAL

VIII. Authorized Official

Name: TAMARA R YANCEY
Title or Position: OWNER/PHARMACIST
Credential: R.PH.
Phone: 205-993-4123