Organization
KATE POWELL JORDAN
Active
Other names
THE MEDICINE CHEST
Organization subpart
No
Provider details
NPI number
Authorized official
ALLEN JORDAN RPH (MANAGER)
(251) 275-1000
Entity
Organization
Contact information
Practice address
126 MAIN ST, GROVE HILL, AL 36451-3144
(251) 275-1000
(251) 275-1003
Mailing address
PO BOX 69, GROVE HILL, AL 36451-0069
(251) 275-1000
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
111046
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100002866
—
AL
01
—
1993922
PK
—
Enumeration date
08/10/2006
Last updated
02/20/2017
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