Organization
CLOVERLAND DRUG, INC
Active
Other names
Fountain City Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
DAVID SAALWAECHTER RPH (PRESIDENT)
(334) 322-2927
Entity
Organization
Contact information
Practice address
105 N MEMORIAL DR, PRATTVILLE, AL 36067-3332
(334) 365-3327
(334) 365-3316
Mailing address
PO BOX 240817, MONTGOMERY, AL 36124-0817
(334) 386-2742
(334) 386-2745
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
Primary
104085
AL
3336C0003X
Community/Retail Pharmacy
—
—
3336C0004X
Compounding Pharmacy
—
—
3336M0002X
Mail Order Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
156110
—
AL
01
—
2143927
PK
—
Enumeration date
11/03/2006
Last updated
12/21/2015
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