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General NPI Number Information
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NPI Number | 1457539710
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Entity Type | Organization
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Legal Business Name | PARKS PHARMACY
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Dates
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Enumeration Date | 02/08/2008
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Last Update Date | 07/03/2020
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Provider Practice Location Address
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Address Line | 1323 MULBERRY ST STE A
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City | MONTGOMERY
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State | AL
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Zip | 36106-1545
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Country | US
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Telephone | 334-264-1416
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Fax | 334-264-1426
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Provider Business Mailing Address
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Address Line | PO BOX 250310
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City | MONTGOMERY
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State | AL
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Zip | 36125-0310
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Country | US
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Telephone | 334-799-1489
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Fax | 334-375-4723
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Authorized Official
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Title or Position | PRESIDENT
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Name | LA SONYA GLOVER
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Credential |
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Telephone | 334-799-1489
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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 | 332B00000X
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Taxonomy Name | Durable Medical Equipment & Medical Supplies
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License Number | 113050
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License Number State | AL
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