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General NPI Number Information
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NPI Number | 1124302831
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Entity Type | Organization
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Legal Business Name | WILCO DRUGS LLC
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Dates
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Enumeration Date | 09/30/2011
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Last Update Date | 01/21/2025
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Provider Practice Location Address
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Address Line | 14 INDUSTRIAL LN
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City | SYLVANIA
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State | AL
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Zip | 35988-2273
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Country | US
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Telephone | 256-638-6070
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Fax | 256-638-6075
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Provider Business Mailing Address
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Address Line | 875 ROSS ST
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City | HEFLIN
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State | AL
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Zip | 36264-1131
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Country | US
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Telephone | 256-463-2197
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Fax | 256-646-2054
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Authorized Official
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Title or Position | OWNER/PIC
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Name | FRANK TANT
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Credential |
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Telephone | 256-638-6070
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 333600000X
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Taxonomy Name | Pharmacy
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 3336C0003X
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Taxonomy Name | Community/Retail Pharmacy
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License Number | 112831
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License Number State | AL
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