Organization
MILL STREET PHARMACY INC
Active
Other names
Mill Street Pharmacy Inc
Organization subpart
No
Provider details
NPI number
Authorized official
PATRICK PHILLIPS (OWNER)
(256) 593-5279
Entity
Organization
Contact information
Practice address
10639 AL HIGHWAY 168, BOAZ, AL 35957-1955
(256) 593-5279
(256) 593-1991
Mailing address
10639 AL HIGHWAY 168, BOAZ, AL 35957-1955
(256) 593-5279
(256) 593-1991
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
111177
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
169336
—
AL
01
—
2150239
PK
—
Enumeration date
09/01/2006
Last updated
02/22/2017
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