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General NPI Number Information
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NPI Number | 1417017658
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Entity Type | Organization
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Legal Business Name | FARMERVILLE DRUG CO INC
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Dates
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Enumeration Date | 12/11/2006
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Last Update Date | 01/06/2011
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Provider Practice Location Address
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Address Line | 300 E WATER ST
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City | FARMERVILLE
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State | LA
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Zip | 71241-3032
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Country | US
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Telephone | 318-368-9711
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Fax | 318-368-8567
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Provider Business Mailing Address
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Address Line | 300 E WATER ST
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City | FARMERVILLE
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State | LA
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Zip | 71241-3032
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Country | US
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Telephone | 318-368-9711
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Fax | 318-368-8567
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Authorized Official
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Title or Position | PRES OWNER
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Name | GARY ALBRITTON
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Credential |
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Telephone | 318-368-9711
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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 | PHY000356IR
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License Number State | LA
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