Organization
DOTHAN BEHAVIORAL MEDICINE CLINIC PC
Active
Other names
Dothan Behavioral Medicine Clinic Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
SUSANNAH DAUGHTRY B.S. PHARMACY (DIRECTOR OF PHARMACY)
(334) 796-1548
Entity
Organization
Contact information
Practice address
408 HEALTHWEST DR, DOTHAN, AL 36303-2054
(334) 479-0541
(334) 479-0586
Mailing address
408 HEALTHWEST DR, DOTHAN, AL 36303-2054
(334) 479-0541
(334) 479-0586
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
114222
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
154463
—
AL
01
—
2143097
PK
—
Enumeration date
11/27/2013
Last updated
01/18/2017
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