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Organization
ST FLORIAN PHARMACY INC
Active
Organization
ST FLORIAN PHARMACY INC
Active
Other names
St. Florian Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
DEREK RAY (OWNER, PRES, TCH, AO)
(256) 765-0123
Entity
Organization
Contact information
Practice address
4395 COUNTY ROAD 47, FLORENCE, AL 35630-8998
(256) 765-0123
(256) 765-0124
Mailing address
4395 COUNTY ROAD 47, FLORENCE, AL 35630-8998
(256) 765-0123
(256) 765-0124
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
NULL
3336C0003X
Community/Retail Pharmacy
Primary
114756
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2171240
PK
—
Enumeration date
08/24/2017
Last updated
07/19/2018
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