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General NPI Number Information
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NPI Number | 1679605984
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Entity Type | Organization
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Legal Business Name | LITTLE DRUG COMPANY, LLC
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Dates
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Enumeration Date | 03/12/2007
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Last Update Date | 01/17/2014
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Provider Practice Location Address
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Address Line | 310 MAIN ST S
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City | LINDEN
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State | AL
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Zip | 36748
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Country | US
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Telephone | 334-295-4270
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Fax | 334-295-0141
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Provider Business Mailing Address
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Address Line | PO BOX 480999
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City | LINDEN
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State | AL
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Zip | 36748-0999
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Country | US
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Telephone | 334-295-4270
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Fax | 334-295-0141
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Authorized Official
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Title or Position | OWNER
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Name | MR. RICHARD LAMAR BOONE
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Credential | R.PH.
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Telephone | 334-295-4270
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3336L0003X
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Taxonomy Name | Long Term Care Pharmacy
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License Number | 112401
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License Number State | AL
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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 | 112401
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License Number State | AL
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