# SHOALS FAMILY PHARMACY GROUP INC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Family Pharmacy of Russellville
- **Organization subpart:** No

## Provider details

- **NPI number:** 1134454150
- **Authorized official:** JEREMY HEATH LANE (PHARMACIST)
- **Authorized official phone:** (256) 332-5545

## Contact information

- **Practice address:** 455 UNDERWOOD RD, RUSSELLVILLE, AL 35653-4111
- **Practice address phone:** (256) 332-5545
- **Practice address fax:** (256) 332-5582
- **Mailing address:** 455 UNDERWOOD RD, RUSSELLVILLE, AL 35653-4111
- **Mailing address phone:** (256) 332-5545
- **Mailing address fax:** (256) 332-5582

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 333600000X | Pharmacy | — | NULL | — |
| 3336C0003X | Community/Retail Pharmacy | 113307 | AL | Yes |

## Other

- **Enumeration date:** 10/08/2009
- **Last updated:** 05/07/2026

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 114855 | — | AL |
| 01 | — | 2122269 | PK | — |