Organization
EDMONDSON DRUG COMPANY INC
Active
Other names
LAKESIDE PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
CHARLOTTE EDMONDSON PHARMD (OWNER AND PHARMACIST)
(256) 287-9099
Entity
Organization
Contact information
Practice address
445 AL HIGHWAY 69 S STE D, HANCEVILLE, AL 35077-3437
(256) 287-9099
(256) 287-2817
Mailing address
PO BOX 789, CULLMAN, AL 35056-0789
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
111500
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100003509
—
AL
01
—
1995236
PK
—
Enumeration date
06/11/2006
Last updated
08/19/2015
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