Organization
PARKS AVENUE DRUGS
Active
Other names
Parks Avenue Drugs
Organization subpart
No
Provider details
NPI number
Authorized official
WILLIAM HANEY (SUPERVISOR PHARMACIST)
(256) 999-0410
Entity
Organization
Contact information
Practice address
410 PARKS AVE STE F, SCOTTSBORO, AL 35768-2437
(256) 999-0410
(256) 999-0411
Mailing address
410 PARKS AVE STE F, SCOTTSBORO, AL 35768-2437
(256) 999-0410
(256) 999-0411
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
3336C0003X
Community/Retail Pharmacy
Primary
114439
AL
3336C0004X
Compounding Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2149300
PK
—
Enumeration date
12/16/2014
Last updated
12/16/2014
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