Organization
DURA-MED SOUTHEAST INC
Active
Other names
Evergreen City Drugs
Organization subpart
No
Provider details
NPI number
Authorized official
MISTY HERRING (PHARMACIST)
(850) 675-6850
Entity
Organization
Contact information
Practice address
110 LEWIS ST, EVERGREEN, AL 36401-3317
(251) 578-9065
(251) 578-1006
Mailing address
110 LEWIS ST, EVERGREEN, AL 36401-3317
(251) 578-9065
(251) 578-1006
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
113840
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0137489
NCPDP PROVIDER IDENTIFICATION NUMBER
—
Enumeration date
09/28/2011
Last updated
01/12/2012
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