# ISLAND DRUG, LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** ISLAND DRUG INC
- **Organization subpart:** No

## Provider details

- **NPI number:** 1881861383
- **Authorized official:** MICHAEL TILLIS (OWNER)
- **Authorized official phone:** (228) 217-5192

## Contact information

- **Practice address:** 3645 GULF SHORES PARKWAY, STE 107, GULF SHORES, AL 36542-2721
- **Practice address phone:** (251) 967-1100
- **Practice address fax:** (251) 967-1200
- **Mailing address:** P.O. BOX 4147, GULF SHORES, AL 36547
- **Mailing address phone:** (251) 967-1100
- **Mailing address fax:** (251) 967-1200

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 333600000X | Pharmacy | — | NULL | — |
| 3336C0003X | Community/Retail Pharmacy | 113101 | AL | Yes |
| 3336C0004X | Compounding Pharmacy | — | NULL | — |

## Other

- **Enumeration date:** 05/14/2008
- **Last updated:** 05/30/2024

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 1881861383 | — | AL |
| 01 | — | 1996299 | PK | — |