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General NPI Number Information
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NPI Number | 1699233114
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Entity Type | Organization
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Legal Business Name | YOUNGS DRUG STORE LLC
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Dates
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Enumeration Date | 03/04/2019
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Last Update Date | 04/01/2022
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Provider Practice Location Address
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Address Line | 24460 HIGHWAY 48
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City | WOODLAND
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State | AL
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Zip | 36280-5204
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Country | US
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Telephone | 256-449-2372
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Fax | 256-449-2379
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Provider Business Mailing Address
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Address Line | PO BOX 67
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City | LINEVILLE
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State | AL
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Zip | 36266-0067
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Country | US
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Telephone | 256-396-5632
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Fax | 256-396-5142
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Authorized Official
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Title or Position | MANGER
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Name | ERIC STANLEY SMITH
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Credential |
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Telephone | 256-449-2372
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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 |
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License Number State |
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