Organization
PARKS PHARMACY INC
Active
Other names
PARKS PHARMACY #1
Organization subpart
No
Provider details
NPI number
Authorized official
DEMETRIUS PARKS (PRESIDENT)
(334) 799-1489
Entity
Organization
Contact information
Practice address
225 HAYNEVILLE PLZ, HAYNEVILLE, AL 36040-2669
(334) 548-6240
(334) 323-5663
Mailing address
PO BOX 250310, MONTGOMERY, AL 36125-0310
(334) 548-6240
(334) 548-6246
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
112816
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0132364
NCPDP PROVIDER IDENTIFICATION NUMBER
—
05
—
100003543
—
AL
05
—
100003578
—
AL
Enumeration date
04/03/2007
Last updated
02/29/2012
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