Organization
SOUTHERN FAMILY MARKETS LLC
Active
Other names
SOUTHERN FAMILY MARKET
Organization subpart
No
Provider details
NPI number
Authorized official
MARK TOW (DIRECTOR OF PHARMACY)
(205) 912-4234
Entity
Organization
Contact information
Practice address
1603 FLORENCE BLVD, FLORENCE, AL 35630
(256) 764-9042
(256) 740-4690
Mailing address
PO BOX 8500, LOCKBOX 8531, PHILADELPHIA, PA 19178-8531
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
111063
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0133164
NCPDP PROVIDER IDENTIFICATION NUMBER
—
05
—
100003632
—
AL
Enumeration date
10/02/2006
Last updated
09/24/2010
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