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General NPI Number Information
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NPI Number | 1447699624
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Entity Type | Organization
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Legal Business Name | BREWER FAMILY PHARMACY INC
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Dates
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Enumeration Date | 06/20/2013
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Last Update Date | 09/02/2014
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Provider Practice Location Address
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Address Line | 1161 HIGHWAY 72
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City | KILLEN
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State | AL
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Zip | 35645-9101
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Country | US
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Telephone | 256-757-0088
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Fax | 256-757-0031
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Provider Business Mailing Address
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Address Line | 1161 HIGHWAY 72
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City | KILLEN
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State | AL
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Zip | 35645-9101
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Country | US
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Telephone | 256-757-0088
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Fax | 256-757-0031
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Authorized Official
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Title or Position | OWNER/PHARMACIST-IN-CHARGE
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Name | MR. MICKEY L BREWER
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Credential | RPH
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Telephone | 256-757-5855
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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 | 114150
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License Number State | AL
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