Organization
YOUNGS DRUG STORE LLC
Active
Other names
YOUNG DRUG STORE
Organization subpart
No
Provider details
NPI number
Authorized official
ERIC SMITH RPH (MNGR, OWNER)
(256) 396-5632
Entity
Organization
Contact information
Practice address
88960 HWY 9, LINEVILLE, AL 36266
(256) 396-5632
(256) 396-5142
Mailing address
PO BOX 67, LINEVILLE, AL 36266-0067
(256) 396-5632
(256) 396-5142
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
12660
AL
3336C0004X
Compounding Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100003274
—
AL
01
—
1988812
PK
—
Enumeration date
08/18/2006
Last updated
01/19/2018
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