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Organization
SHOALS FAMILY PHARMACY GROUP INC
Active
Organization
SHOALS FAMILY PHARMACY GROUP INC
Active
Other names
The Drug Shop of Russellville
Organization subpart
No
Provider details
NPI number
Authorized official
JEREMY LANE (OWNER/PHARMACIST)
(256) 810-3331
Entity
Organization
Contact information
Practice address
318 JACKSON AVE S, SUITE 1, RUSSELLVILLE, AL 35653-2207
(256) 332-8550
(256) 332-8081
Mailing address
455 UNDERWOOD RD, RUSSELLVILLE, AL 35653-4111
(256) 332-5545
(256) 332-5582
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
113306
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2122271
PK
—
Enumeration date
10/26/2009
Last updated
10/20/2015
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