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General NPI Number Information
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NPI Number | 1720056534
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Entity Type | Organization
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Legal Business Name | BUBBA'S PHARMACEUTICAL CARE, INC
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Dates
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Enumeration Date | 03/08/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 207 N 6TH ST
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City | OPELIKA
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State | AL
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Zip | 36801-4229
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Country | US
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Telephone | 334-745-7242
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Fax | 334-745-1510
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Provider Business Mailing Address
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Address Line | 207 N 6TH ST
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City | OPELIKA
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State | AL
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Zip | 36801-4229
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Country | US
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Telephone | 334-745-7242
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Fax | 334-745-1510
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Authorized Official
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Title or Position | OWNER
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Name | WILLIAM M YOUNG
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Credential | PHARMACIST
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Telephone | 334-745-7242
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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 | 112495
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License Number State | AL
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