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Organization
DADEVILLE PHARMACY LLC
Active
Organization
DADEVILLE PHARMACY LLC
Active
Other names
Lakeshore Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
JOE A DALTON RPH (OWNER)
(334) 797-7992
Entity
Organization
Contact information
Practice address
221 E SOUTH ST, DADEVILLE, AL 36853-1923
(256) 825-0063
(256) 825-5584
Mailing address
PO BOX 279, SLOCOMB, AL 36375-0279
(334) 797-7992
(256) 825-5584
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
—
NULL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
226751
—
AL
Enumeration date
12/17/2018
Last updated
11/03/2022
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