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General NPI Number Information
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NPI Number | 1871522029
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Entity Type | Organization
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Legal Business Name | JIFFY WESTSIDE PHARMACY
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Dates
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Enumeration Date | 07/01/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 1204 W MARKET ST
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City | ATHENS
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State | AL
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Zip | 35611-4769
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Country | US
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Telephone | 256-233-2307
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Fax | 256-233-0865
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Provider Business Mailing Address
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Address Line | 1204 W MARKET ST
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City | ATHENS
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State | AL
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Zip | 35611-4769
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Country | US
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Telephone | 256-233-2307
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Fax | 256-233-0865
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Authorized Official
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Title or Position | OWNER/VICE PRESIDENT
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Name | MR. TERRELL G MILBY
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Credential | R.PH.
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Telephone | 25623323307
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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 | 111507
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License Number State | AL
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