Organization
CLEBURNE PHARMACY LLC
Active
Other names
Cleburne Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
FRANK TANT PHARMD (OWNER/PIC/AO)
(256) 463-2197
Entity
Organization
Contact information
Practice address
875 ROSS ST, HEFLIN, AL 36264-1131
(256) 463-2197
(256) 463-2306
Mailing address
875 ROSS ST, HEFLIN, AL 36264-1131
(256) 463-2197
(256) 463-2306
Taxonomy
Speciality
Code
Description
License number
State
291U00000X
Clinical Medical Laboratory
—
—
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
102545
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100000653
—
AL
01
—
2157998
PK
—
Enumeration date
07/08/2006
Last updated
09/11/2025
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