Organization
ST FLORIAN PHARMACY INC
Active
Other names
St. Florian Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
DEREK RAY (OWNER, PRES, TCH, AO)
(256) 765-0123
Entity
Organization
Contact information
Practice address
4395 COUNTY ROAD 47, FLORENCE, AL 35630-8998
(256) 765-0123
(256) 765-0124
Mailing address
4395 COUNTY ROAD 47, FLORENCE, AL 35630-8998
(256) 765-0123
(256) 765-0124
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
114756
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2171240
PK
—
Enumeration date
08/24/2017
Last updated
07/19/2018
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