Organization
MARTIN FAMILY CARE
Active
Other names
Glenn's Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
JEDEDIAH MARTIN (OWNER)
(334) 298-2577
Entity
Organization
Contact information
Practice address
2413 CRAWFORD RD, PHENIX CITY, AL 36867-3648
(334) 298-2577
(334) 291-0190
Mailing address
2413 CRAWFORD RD, PHENIX CITY, AL 36867-3648
(334) 298-2577
(334) 291-0190
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
104605
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
149701
—
AL
01
—
2140744
PK
—
Enumeration date
03/28/2013
Last updated
06/22/2021
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