Healthcare Provider Details

I. General information

NPI: 1093829061
Provider Name (Legal Business Name): WHITAKER DRUGS THOMASVILLE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/18/2006
Last Update Date: 04/30/2025
Certification Date: 04/30/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

470 SAFFORD AVE W
THOMASVILLE AL
36784-3112
US

IV. Provider business mailing address

470 SAFFORD AVE W
THOMASVILLE AL
36784-3112
US

V. Phone/Fax

Practice location:
  • Phone: 334-636-9809
  • Fax: 334-636-9807
Mailing address:
  • Phone: 334-636-9809
  • Fax: 334-636-9807

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 Number103869
License Number StateAL

VIII. Authorized Official

Name: AMANDA WHITAKER
Title or Position: OWNER/PHARMACIST
Credential:
Phone: 334-599-8528