# CLEBURNE PHARMACY LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Cleburne Pharmacy
- **Organization subpart:** No

## Provider details

- **NPI number:** 1649203365
- **Authorized official:** FRANK TANT PHARMD (OWNER/PIC/AO)
- **Authorized official phone:** (256) 463-2197

## Contact information

- **Practice address:** 875 ROSS ST, HEFLIN, AL 36264-1131
- **Practice address phone:** (256) 463-2197
- **Practice address fax:** (256) 463-2306
- **Mailing address:** 875 ROSS ST, HEFLIN, AL 36264-1131
- **Mailing address phone:** (256) 463-2197
- **Mailing address fax:** (256) 463-2306

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 291U00000X | Clinical Medical Laboratory | — | NULL | — |
| 333600000X | Pharmacy | — | NULL | — |
| 3336C0003X | Community/Retail Pharmacy | 102545 | AL | Yes |

## Other

- **Enumeration date:** 07/08/2006
- **Last updated:** 09/11/2025

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 100000653 | — | AL |
| 01 | — | 2157998 | PK | — |