Organization
MIJ LLC
Active
Other names
Progressive Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
SHAKIR MEGHANI (OWNER)
(334) 718-9768
Entity
Organization
Contact information
Practice address
1970 ANDREWS AVE, OZARK, AL 36360-3726
(334) 350-3671
(334) 350-3672
Mailing address
2812 HARTFORD HWY, SUITE 1, DOTHAN, AL 36305-4927
(334) 699-8622
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
202623
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
166432
—
AL
01
—
2147359
PK
—
Enumeration date
06/27/2013
Last updated
03/06/2017
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