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General NPI Number Information
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NPI Number | 1568480507
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Entity Type | Organization
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Legal Business Name | LEE DRUG STORE, INC.
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Dates
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Enumeration Date | 07/18/2006
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Last Update Date | 06/29/2011
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Provider Practice Location Address
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Address Line | 18530 FLORIDA STREET
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City | ROBERTSDALE
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State | AL
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Zip | 36567
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Country | US
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Telephone | 251-947-7378
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Fax | 251-947-7394
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Provider Business Mailing Address
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Address Line | PO BOX 929 18530 FLORIDA ST
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City | ROBERTSDALE
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State | AL
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Zip | 36567-0929
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Country | US
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Telephone | 251-947-7378
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Fax | 251-947-7394
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Authorized Official
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Title or Position | PRESIDENT/TREASURER - LEE DRUG STOR
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Name | MRS. DONNA RAWLS BROWN
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Credential | B.S., MSC, AL PHARM
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Telephone | 251-947-7378
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 106040
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License Number State | AL
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