# MILL STREET PHARMACY INC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Mill Street Pharmacy Inc
- **Organization subpart:** No

## Provider details

- **NPI number:** 1295837300
- **Authorized official:** PATRICK PHILLIPS (OWNER)
- **Authorized official phone:** (256) 593-5279

## Contact information

- **Practice address:** 10639 AL HIGHWAY 168, BOAZ, AL 35957-1955
- **Practice address phone:** (256) 593-5279
- **Practice address fax:** (256) 593-1991
- **Mailing address:** 10639 AL HIGHWAY 168, BOAZ, AL 35957-1955
- **Mailing address phone:** (256) 593-5279
- **Mailing address fax:** (256) 593-1991

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 333600000X | Pharmacy | — | NULL | — |
| 3336C0003X | Community/Retail Pharmacy | 111177 | AL | Yes |

## Other

- **Enumeration date:** 09/01/2006
- **Last updated:** 02/22/2017

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 169336 | — | AL |
| 01 | — | 2150239 | PK | — |