Healthcare Provider Details

I. General information

NPI: 1336135367
Provider Name (Legal Business Name): WOODSTOCK DRUG INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/26/2005
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

28891 HIGHWAY 5
WOODSTOCK AL
35188-3614
US

IV. Provider business mailing address

PO BOX 280
WOODSTOCK AL
35188-0280
US

V. Phone/Fax

Practice location:
  • Phone: 205-938-9221
  • Fax: 205-938-9290
Mailing address:
  • Phone: 205-938-9221
  • Fax: 205-938-9290

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number110245
License Number StateAL

VIII. Authorized Official

Name: DAVID F ROOKER
Title or Position: PRESIDENT
Credential: RPH
Phone: 205-938-9221