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General NPI Number Information
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NPI Number | 1770655904
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Entity Type | Organization
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Legal Business Name | BOONE PHARMACY MANAGEMENT INC
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Dates
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Enumeration Date | 11/14/2006
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Last Update Date | 01/06/2025
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Provider Practice Location Address
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Address Line | 201 COMMERCE ST
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City | JACKSON
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State | AL
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Zip | 36545-2717
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Country | US
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Telephone | 251-246-2271
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Fax | 251-246-2277
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Provider Business Mailing Address
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Address Line | PO BOX 426
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City | JACKSON
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State | AL
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Zip | 36545-0426
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Country | US
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Telephone | 251-246-2271
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Fax | 251-246-2277
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Authorized Official
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Title or Position | PRESIDENT
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Name | RICHARD BOONE
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Credential |
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Telephone | 334-341-3466
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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 | 106440
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License Number State | AL
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