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Organization
MILL STREET PHARMACY INC
Active
Organization
MILL STREET PHARMACY INC
Active
Other names
Mill Street Pharmacy Inc
Organization subpart
No
Provider details
NPI number
Authorized official
PATRICK PHILLIPS (OWNER)
(256) 593-5279
Entity
Organization
Contact information
Practice address
10639 AL HIGHWAY 168, BOAZ, AL 35957-1955
(256) 593-5279
(256) 593-1991
Mailing address
10639 AL HIGHWAY 168, BOAZ, AL 35957-1955
(256) 593-5279
(256) 593-1991
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
NULL
3336C0003X
Community/Retail Pharmacy
Primary
111177
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
169336
—
AL
01
—
2150239
PK
—
Enumeration date
09/01/2006
Last updated
02/22/2017
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