Organization
SHOALS FAMILY PHARMACY GROUP INC
Active
Other names
The Drug Shop of Russellville
Organization subpart
No
Provider details
NPI number
Authorized official
JEREMY LANE (OWNER/PHARMACIST)
(256) 810-3331
Entity
Organization
Contact information
Practice address
318 JACKSON AVE S, SUITE 1, RUSSELLVILLE, AL 35653-2207
(256) 332-8550
(256) 332-8081
Mailing address
455 UNDERWOOD RD, RUSSELLVILLE, AL 35653-4111
(256) 332-5545
(256) 332-5582
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
113306
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2122271
PK
—
Enumeration date
10/26/2009
Last updated
10/20/2015
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