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General NPI Number Information
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NPI Number | 1861586125
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Entity Type | Organization
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Legal Business Name | PISGAH FAMILY PHARMACY LLC
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Dates
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Enumeration Date | 10/03/2006
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Last Update Date | 02/07/2014
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Provider Practice Location Address
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Address Line | 6049 COUNTY ROAD 88
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City | PISGAH
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State | AL
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Zip | 35765
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Country | US
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Telephone | 256-451-3283
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Fax | 256-451-6088
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Provider Business Mailing Address
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Address Line | PO BOX 9
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City | PISGAH
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State | AL
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Zip | 35765-0009
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Country | US
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Telephone | 256-451-3283
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Fax | 256-451-6088
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Authorized Official
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Title or Position | OWNER
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Name | STEVEN OVERBY
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Credential | PHARMD
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Telephone | 256-451-3283
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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 | 107810
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License Number State | AL
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