Organization
CITY DRUG STORE, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. HORACE BAILEY RPH (PRESIDENT)
(334) 222-1131
Entity
Organization
Contact information
Practice address
224 S THREE NOTCH ST, ANDALUSIA, AL 36420
(334) 222-1131
(334) 222-6212
Mailing address
224 S THREE NOTCH ST, POST OFFICE BOX 909, ANDALUSIA, AL 36420-3710
(334) 222-1131
(334) 222-6212
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
111849
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0103731
NCPDP ID
AL
05
—
100000391
—
AL
01
—
111849
ALABAMA PHARMACY LICENSE
AL
Enumeration date
02/08/2007
Last updated
03/31/2011
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