MEDICARE: FOSTER DRUG CO 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	3336C0003X	Community/Retail Pharmacy	104075	AL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier Issuer
1	1988742	OTHER	PK
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1689607624
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	FOSTER DRUG CO INC

Provider Business Mailing Address
First Line	:	PO BOX 366
Second Line	:
City	:	HAYNEVILLE
State	:	AL
Zip	:	36040-0366
Country	:	US
Telephone Number	:	334-548-2125
Fax Number	:	334-548-2126

Provider Business Practice Location Address
First Line	:	12 LAFAYETTE ST
Second Line	:
City	:	HAYNEVILLE
State	:	AL
Zip	:	36040-2089
Country	:	US
Telephone Number	:	334-548-2125
Fax Number	:	334-548-2126

Authorized Official
Title or Position	:	OWNER, PIC, AO
Name	:	JOHN CARPENTER
Credential	:	RPH
Telephone Number	:	334-548-2125

Provider Enumeration Date	:	07/09/2006
Last Update Date	:	01/19/2018

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Directions to “FOSTER DRUG CO INC ” Practice Location

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