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General NPI Number Information
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NPI Number | 1396177986
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Entity Type | Organization
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Legal Business Name | RIVERWOOD PHARMACY LLC
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Dates
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Enumeration Date | 08/06/2013
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Last Update Date | 12/19/2014
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Provider Practice Location Address
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Address Line | 100 RICE MINE ROAD SUITE B
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City | TUSCALOOSA
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State | AL
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Zip | 35406
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Country | US
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Telephone | 205-469-2270
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Fax | 205-469-2269
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Provider Business Mailing Address
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Address Line | 100 RICE MINE ROAD SUITE B
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City | TUSCALOOSA
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State | AL
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Zip | 35406
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Country | US
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Telephone | 205-469-2270
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Fax | 205-469-2269
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Authorized Official
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Title or Position | PHARMACY MANAGER
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Name | BILL COCKRELL
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Credential |
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Telephone | 205-208-0012
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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 | 114169
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License Number State | AL
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