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General NPI Number Information
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NPI Number | 1487063996
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Entity Type | Organization
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Legal Business Name | GULF COAST SPECIALTY PHARMACY LLC
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Dates
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Enumeration Date | 08/08/2014
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Last Update Date | 08/08/2014
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Provider Practice Location Address
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Address Line | 110-A EAST AZALEA AVE
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City | FOLEY
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State | AL
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Zip | 36535
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Country | US
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Telephone | 251-424-1487
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Fax | 800-638-9321
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Provider Business Mailing Address
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Address Line | 110-A EAST AZALEA AVE
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City | FOLEY
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State | AL
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Zip | 36535
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Country | US
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Telephone | 251-424-1487
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Fax | 800-638-9321
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Authorized Official
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Title or Position | PHARMACIST IN CHARGE
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Name | DR. ELIZABETH CATLIN STATON
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Credential | PHARMD
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Telephone | 251-424-1487
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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 | 114395
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License Number State | AL
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