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General NPI Number Information
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NPI Number | 1235567355
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Entity Type | Organization
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Legal Business Name | FOODLAND PHARMACY SB LLC
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Dates
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Enumeration Date | 10/29/2013
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Last Update Date | 07/08/2024
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Provider Practice Location Address
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Address Line | 1402 COUNTY PARK RD STE 1
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City | SCOTTSBORO
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State | AL
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Zip | 35769-3968
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Country | US
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Telephone | 256-259-1011
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Fax | 256-259-1138
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Provider Business Mailing Address
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Address Line | 1402 COUNTY PARK RD STE 1
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City | SCOTTSBORO
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State | AL
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Zip | 35769-3968
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Country | US
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Telephone | 256-259-1011
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Fax | 256-259-1138
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Authorized Official
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Title or Position | PHARMACY MANAGER/OWNER
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Name | DR. DAVID JOHN KINSLEY
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Credential | PHARM.D.
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Telephone | 256-259-1011
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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 | 114233
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License Number State | AL
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