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General NPI Number Information
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NPI Number | 1144520446
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Entity Type | Organization
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Legal Business Name | EAGLE DRUGS LLC
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Dates
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Enumeration Date | 11/02/2010
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Last Update Date | 06/23/2011
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Provider Practice Location Address
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Address Line | 3705 HWY 431
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City | ROANOKE
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State | AL
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Zip | 36274
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Country | US
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Telephone | 334-863-6337
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 607
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City | ROANOKE
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State | AL
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Zip | 36274-0607
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | MEMBER
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Name | ERIC SMITH
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Credential | RPH
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Telephone | 256-276-4141
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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 | 113460
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License Number State | AL
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