Organization
GOODWATER PHARMACY INC
Active
Other names
GOODWATER PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
RICHARD COLLINS RPH (PRESIDENT)
(256) 839-6361
Entity
Organization
Contact information
Practice address
21338 AL HIGHWAY 9, GOODWATER, AL 35072-6621
(256) 839-6361
(256) 839-6481
Mailing address
PO BOX 48, GOODWATER, AL 35072-0048
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
112684
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100003637
—
AL
01
—
1995706
PK
—
Enumeration date
09/12/2006
Last updated
01/13/2017
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