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Organization
FORT DEPOSIT DRUG PHARMACY LLC
Active
Organization
FORT DEPOSIT DRUG PHARMACY LLC
Active
Other names
FORT DEPOSIT DRUG PHARMACY LLC
Organization subpart
No
Provider details
NPI number
Authorized official
KENNETH HAYES (PRESIDENT)
(205) 401-7911
Entity
Organization
Contact information
Practice address
120 S POLLARD ST, FORT DEPOSIT, AL 36032-3825
(334) 227-7777
(334) 227-4466
Mailing address
PO BOX 280, FORT DEPOSIT, AL 36032-0280
(334) 227-7777
(334) 227-4466
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
113013
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0135029
NCPDP PROVIDER IDENTIFICATION NUMBER
—
05
—
113013
—
AL
Enumeration date
01/08/2008
Last updated
05/25/2011
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