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Organization
EDMONDSON DRUG COMPANY INC
Active
Organization
EDMONDSON DRUG COMPANY INC
Active
Other names
LAKESIDE PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
CHARLOTTE EDMONDSON PHARMD (OWNER AND PHARMACIST)
(256) 287-9099
Entity
Organization
Contact information
Practice address
445 AL HIGHWAY 69 S STE D, HANCEVILLE, AL 35077-3437
(256) 287-9099
(256) 287-2817
Mailing address
PO BOX 789, CULLMAN, AL 35056-0789
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
NULL
333600000X
Pharmacy
—
NULL
3336C0003X
Community/Retail Pharmacy
Primary
111500
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100003509
—
AL
01
—
1995236
PK
—
Enumeration date
06/11/2006
Last updated
08/19/2015
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