# GENTRY PHARMACY LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Gentry Health Mart Pharmacy
- **Organization subpart:** No

## Provider details

- **NPI number:** 1578857108
- **Authorized official:** ROBERT CLINT GENTRY PHARMD (OWNER/MANAGER)
- **Authorized official phone:** (205) 970-1983

## Contact information

- **Practice address:** 3100 BLUE LAKE DRIVE, VESTAVIA, AL 35243
- **Practice address phone:** (205) 970-1983
- **Practice address fax:** (205) 970-1986
- **Mailing address:** 3100 BLUE LAKE DRIVE, VESTAVIA, AL 35243
- **Mailing address phone:** (205) 970-1983
- **Mailing address fax:** (205) 970-1986

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 333600000X | Pharmacy | — | NULL | — |
| 3336C0003X | Community/Retail Pharmacy | 113729 | AL | Yes |
| 3336C0004X | Compounding Pharmacy | — | NULL | — |

## Other

- **Enumeration date:** 05/31/2011
- **Last updated:** 08/19/2021

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 129374 | — | AL |
| 01 | — | 2130074 | PK | — |