Organization
WETUMPKA PHARMACY
Active
Other names
Wetumpka Pharmacy, LLC
Organization subpart
No
Provider details
NPI number
Authorized official
JUAN LATORRE PHARMD (OWNER)
(334) 567-5442
Entity
Organization
Contact information
Practice address
277 HUNTRESS ST, SUITE 101, WETUMPKA, AL 36092
(334) 567-5442
(334) 567-5423
Mailing address
277 HUNTRESS ST, SUITE 101, WETUMPKA, AL 36092
(334) 567-5442
(334) 567-5423
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
113792
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2131485
PK
—
Enumeration date
08/24/2011
Last updated
07/02/2020
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