Organization
JB GILLESPIE DRUGS INC
Active
Other names
MEDICINE SHOPPE
Organization subpart
No
Provider details
NPI number
Authorized official
SUSAN GUINN (MEDICAID MEDICARE BILLING SPEC)
(314) 993-6000
Entity
Organization
Contact information
Practice address
2701 PATTON RD SW, HUNTSVILLE, AL 35805-4352
(256) 536-1910
(256) 536-1722
Mailing address
2701 PATTON RD SW, HUNTSVILLE, AL 35805-4352
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
110709
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0126777
NCPDP PROVIDER IDENTIFICATION NUMBER
—
05
—
100002808
—
AL
Enumeration date
08/20/2006
Last updated
03/07/2023
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