Organization
DRUID CITY INFUSION
Active
Other names
Druid City Vital Care
Organization subpart
No
Provider details
NPI number
Authorized official
LOGAN DAVIS PHARMD (OWNER)
(601) 482-7420
Entity
Organization
Contact information
Practice address
611 MCFARLAND BLVD, SUITE C, NORTHPORT, AL 35476-3333
(205) 409-9601
(205) 449-7509
Mailing address
611 MCFARLAND BLVD, SUITE C, NORTHPORT, AL 35476-3333
(205) 409-9601
(205) 449-7509
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
114274
AL
332BP3500X
Parenteral & Enteral Nutrition Supplies (DME)
114274
AL
333600000X
Pharmacy
114274
AL
3336H0001X
Home Infusion Therapy Pharmacy
Primary
114274
AL
3336L0003X
Long Term Care Pharmacy
114274
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
158481
—
AL
05
—
163996
—
AL
01
—
511-50337
BCBS AL
AL
Enumeration date
12/02/2013
Last updated
07/10/2020
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