MEDICARE: YORK DRUG INC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	333600000X	Pharmacy
2	3336I0012X	Institutional Pharmacy
3	3336L0003X	Long Term Care Pharmacy	111338	AL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	0128834	OTHER		NCPDP PROVIDER IDENTIFICATION NUMBER
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1013943273
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	YORK DRUG INC

Provider Business Mailing Address
First Line	:	PO BOX 577
Second Line	:
City	:	YORK
State	:	AL
Zip	:	36925-0577
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	400 COUNTRY CLUB RD
Second Line	:
City	:	YORK
State	:	AL
Zip	:	36925-2027
Country	:	US
Telephone Number	:	205-392-5201
Fax Number	:	205-392-5636

Authorized Official
Title or Position	:	OWNER
Name	:	L EDDIE DAVIS
Credential	:	RPH
Telephone Number	:	205-392-5201

Provider Enumeration Date	:	06/22/2006
Last Update Date	:	09/09/2010

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Directions to “YORK DRUG INC ” Practice Location

Language	Start Address	Practice Location

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