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General NPI Number Information
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NPI Number | 1316026164
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Entity Type | Organization
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Legal Business Name | CLOVERLAND DRUG, INC
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Dates
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Enumeration Date | 11/03/2006
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Last Update Date | 12/21/2015
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Provider Practice Location Address
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Address Line | 105 N MEMORIAL DR
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City | PRATTVILLE
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State | AL
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Zip | 36067-3332
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Country | US
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Telephone | 334-365-3327
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Fax | 334-365-3316
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Provider Business Mailing Address
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Address Line | PO BOX 240817
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City | MONTGOMERY
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State | AL
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Zip | 36124-0817
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Country | US
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Telephone | 334-386-2742
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Fax | 334-386-2745
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Authorized Official
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Title or Position | PRESIDENT
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Name | DAVID SAALWAECHTER
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Credential | RPH
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Telephone | 334-322-2927
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3336M0002X
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Taxonomy Name | Mail Order 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 | 3336C0004X
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Taxonomy Name | Compounding Pharmacy
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License Number |
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License Number State |
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Taxonomy #3
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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 |
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Taxonomy #4
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Taxonomy Code | 333600000X
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Taxonomy Name | Pharmacy
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License Number | 104085
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License Number State | AL
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