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General NPI Number Information
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NPI Number | 1780287904
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Entity Type | Organization
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Legal Business Name | BOONES PHARMACY INC
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Dates
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Enumeration Date | 11/19/2020
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Last Update Date | 02/18/2021
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Provider Practice Location Address
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Address Line | 203 LAFAYETTE STREET
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City | LIVINGSTON
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State | AL
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Zip | 36732-3673
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Country | US
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Telephone | 334-341-3350
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Fax |
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Provider Business Mailing Address
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Address Line | 951 US HIGHWAY 80 W # B
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City | DEMOPOLIS
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State | AL
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Zip | 36732-4156
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Country | US
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Telephone | 334-289-8989
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Fax |
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Authorized Official
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Title or Position | OWNER/PHARMACIST
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Name | MR. RAYMOND L. BOONE
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Credential | RPH
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Telephone | 334-289-8989
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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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