Organization
THE DRUG SHOP LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JIMMY GREG LANE (OWNER RPH)
(256) 332-4021
Entity
Organization
Contact information
Practice address
104 MONTGOMERY ST SW, RUSSELLVILLE, AL 35653
(256) 332-3022
(256) 332-3036
Mailing address
104 MONTGOMERY ST SW, RUSSELLVILLE, AL 35653
(256) 332-3022
(256) 332-3036
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
110481
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0109430
NCPDP
—
Enumeration date
03/22/2006
Last updated
08/22/2020
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