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General NPI Number Information
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NPI Number | 1528471547
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Entity Type | Organization
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Legal Business Name | FAMILY DISCOUNT PHARMACY INC
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Dates
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Enumeration Date | 06/06/2014
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Last Update Date | 03/02/2015
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Provider Practice Location Address
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Address Line | 2117 DOUGLAS AVE
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City | BREWTON
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State | AL
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Zip | 36426-1163
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Country | US
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Telephone | 251-867-3001
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Fax |
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Provider Business Mailing Address
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Address Line | 4833 CHAUDRON RD
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City | MOLINO
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State | FL
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Zip | 32577-6008
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Country | US
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Telephone | 850-587-4008
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Fax |
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Authorized Official
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Title or Position | VP/SECRETARY/TREASURER
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Name | CHARITY SHELDT
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Credential |
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Telephone | 850-587-4008
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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 | 114384
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License Number State | AL
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