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General NPI Number Information
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NPI Number | 1508917584
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Entity Type | Organization
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Legal Business Name | MEDICAL ARTS PHARMACY INC
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Dates
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Enumeration Date | 01/16/2007
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Last Update Date | 09/12/2007
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Provider Practice Location Address
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Address Line | 219 FORTNER ST
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City | DOTHAN
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State | AL
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Zip | 36301-2405
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Country | US
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Telephone | 334-794-4191
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Fax | 334-793-5742
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Provider Business Mailing Address
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Address Line | 219 FORTNER ST
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City | DOTHAN
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State | AL
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Zip | 36301-2405
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | PRESIDENT AND OWNER
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Name | LARRY BOND
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Credential |
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Telephone | 334-794-4191
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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 | 110705
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License Number State | AL
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