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General NPI Number Information
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NPI Number | 1972686012
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Entity Type | Organization
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Legal Business Name | ST CLAIR DRUG COMPANY LLC
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Dates
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Enumeration Date | 10/23/2006
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Last Update Date | 08/16/2018
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Provider Practice Location Address
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Address Line | 45 RICHEY STREET
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City | GERALDINE
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State | AL
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Zip | 35974-3748
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Country | US
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Telephone | 256-659-2117
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Fax | 256-659-2117
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Provider Business Mailing Address
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Address Line | PO BOX 158
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City | GERALDINE
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State | AL
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Zip | 35974-0158
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Country | US
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Telephone | 256-659-2117
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DANIEL ST CLAIR
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Credential |
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Telephone | 256-504-5804
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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 |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 3336C0003X
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Taxonomy Name | Community/Retail Pharmacy
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License Number | 104380
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License Number State | AL
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