Organization
FAYETTE PHARMACY INC
Active
Other names
FAYETTE PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
SUMMER WILSON (PHRMD)
(205) 712-1685
Entity
Organization
Contact information
Practice address
1128 2ND AVE NE, FAYETTE, AL 35555-1739
(205) 932-5400
(205) 932-5401
Mailing address
1128 2ND AVE NE, FAYETTE, AL 35555-1739
(205) 932-5400
(205) 932-5401
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
113087
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0135233
NCPDP PROVIDER IDENTIFICATION NUMBER
—
Enumeration date
04/17/2008
Last updated
07/26/2011
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