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General NPI Number Information
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NPI Number | 1891965315
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Entity Type | Organization
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Legal Business Name | BRYARS-WARREN DRUG CO
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Dates
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Enumeration Date | 03/12/2008
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Last Update Date | 03/12/2008
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Provider Practice Location Address
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Address Line | 112 N MAIN ST
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City | ENTERPRISE
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State | AL
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Zip | 36330-2537
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Country | US
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Telephone | 334-347-2506
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Fax | 334-393-8155
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Provider Business Mailing Address
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Address Line | 112 N MAIN ST
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City | ENTERPRISE
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State | AL
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Zip | 36330-2537
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Country | US
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Telephone | 334-347-2506
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Fax | 334-393-8155
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Authorized Official
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Title or Position | OWNER/PHARMACIST
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Name | GEORGE R CANNON
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Credential |
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Telephone | 334-347-2506
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 333600000X
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Taxonomy Name | Pharmacy
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License Number | 101880
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License Number State | AL
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