Organization
BREWTON MEDICAL CENTER PHARMACY PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CHARLES DANIEL COTTRELL (OWNER/PIC)
(251) 802-0387
Entity
Organization
Contact information
Practice address
1121 BELLEVILLE AVE, BREWTON, AL 36426-1500
(251) 867-5454
Mailing address
1121 BELLEVILLE AVE, BREWTON, AL 36426-1500
(251) 867-5454
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
22158
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100000228
—
AL
Enumeration date
07/02/2007
Last updated
11/19/2025
Update your record
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