# PELL CITY PHARMACY INC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Pell City Pharmacy
- **Organization subpart:** No

## Provider details

- **NPI number:** 1073748877
- **Authorized official:** TUCKER MALONE (PHARMACIST/OWNER)
- **Authorized official phone:** (334) 444-0376

## Contact information

- **Practice address:** 1027 MARTIN ST S, PELL CITY, AL 35128-2360
- **Practice address phone:** (205) 338-6080
- **Practice address fax:** (205) 338-6082
- **Mailing address:** 1027 MARTIN ST S, PELL CITY, AL 35128-2360
- **Mailing address phone:** (205) 338-6080
- **Mailing address fax:** (205) 338-6082

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 333600000X | Pharmacy | — | NULL | — |
| 3336C0003X | Community/Retail Pharmacy | 113272 | AL | Yes |

## Other

- **Enumeration date:** 05/21/2009
- **Last updated:** 02/20/2017

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 1073748877 | — | AL |
| 01 | — | 2120548 | PK | — |