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General NPI Number Information
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NPI Number | 1053670687
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Entity Type | Organization
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Legal Business Name | BERRY DISCOUNT APOTHECARY
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Dates
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Enumeration Date | 05/16/2012
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Last Update Date | 06/01/2012
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Provider Practice Location Address
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Address Line | 31 DEPOT ST
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City | BERRY
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State | AL
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Zip | 35546-2086
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Country | US
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Telephone | 205-689-4777
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Fax | 205-689-4778
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Provider Business Mailing Address
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Address Line | 31 DEPOT ST P.O. BOX 424
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City | BERRY
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State | AL
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Zip | 35546-2086
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Country | US
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Telephone | 205-689-4777
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Fax | 205-689-4778
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Authorized Official
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Title or Position | OWNER
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Name | MR. GEORGE R BOLLING JR.
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Credential | RPH
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Telephone | 205-689-4777
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3336C0003X
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Taxonomy Name | Community/Retail Pharmacy
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License Number |
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License Number State | AL
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