Organization
MEDICAL PARK PHARMACY INC
Active
Other names
Medical Park Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
MR. NORMAN WILLARD DAVIS RPH (PRES)
(334) 298-4010
Entity
Organization
Contact information
Practice address
1623 21ST CT, PHENIX CITY, AL 36867
(334) 298-4010
(334) 298-0342
Mailing address
1623 21ST CT, PHENIX CITY, AL 36867
(334) 298-4010
(334) 298-0342
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
Primary
106743
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00176063A
—
GA
01
—
0114289
NABP
—
Enumeration date
09/28/2006
Last updated
08/22/2020
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