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General NPI Number Information
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NPI Number | 1497197644
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Entity Type | Organization
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Legal Business Name | OMEGA DRUGS,LLC
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Dates
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Enumeration Date | 07/29/2013
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Last Update Date | 08/28/2013
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Provider Practice Location Address
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Address Line | 203 W LEE ST
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City | TUSKEGEE
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State | AL
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Zip | 36083-1719
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Country | US
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Telephone | 334-727-7636
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Fax |
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Provider Business Mailing Address
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Address Line | 203 W LEE ST
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City | TUSKEGEE
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State | AL
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Zip | 36083-1719
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Country | US
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Telephone | 334-727-7636
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | CLINTON OMEGA ADAMS
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Credential | PHARMD
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Telephone | 334-727-7636
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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 | 114172
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License Number State | AL
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