Organization
COLLINSVILLE EXPRESS DRUGS LLC
Active
Other names
collinsville drugs
Organization subpart
No
Provider details
NPI number
Authorized official
BRANDON BOSWELL (OWNER/PIC)
(256) 524-2981
Entity
Organization
Contact information
Practice address
588 S VALLEY AVE, COLLINSVILLE, AL 35961-3535
(256) 524-2981
(256) 524-2987
Mailing address
PO BOX 4498, COLLINSVILLE, AL 35961
(256) 524-2981
(256) 524-2987
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
Primary
112980
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0138467
NCPDP PROVIDER IDENTIFICATION NUMBER
—
Enumeration date
01/18/2013
Last updated
03/12/2013
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