MEDICARE: MILLRY DRUGS, LLC

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	3336C0003X	Community/Retail Pharmacy	111191	AL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	1994009	OTHER		PK

General Provider Information

NPI Number	:	1407061526
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MILLRY DRUGS, LLC

Provider Business Mailing Address
First Line	:	PO BOX 199
Second Line	:
City	:	MILLRY
State	:	AL
Zip	:	36558-0199
Country	:	US
Telephone Number	:	251-846-6290
Fax Number	:

Provider Business Practice Location Address
First Line	:	30282 HWY 17 N
Second Line	:
City	:	MILLRY
State	:	AL
Zip	:	36558
Country	:	US
Telephone Number	:	251-846-6290
Fax Number	:	251-846-6208

Authorized Official
Title or Position	:	OFFICE MANAGER
Name	:	SHARON THOMPSON
Credential	:
Telephone Number	:	251-846-6208

Provider Enumeration Date	:	05/11/2007
Last Update Date	:	11/09/2021

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Directions to “MILLRY DRUGS, LLC ” Practice Location

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