Organization
SOUTHERN FAMILY MARKETS LLC
Active
Other names
SOUTHERN FAMILY MARKET
Organization subpart
No
Provider details
NPI number
Authorized official
MARK TOW (DIRECTOR OF PHARMACY)
(205) 912-4234
Entity
Organization
Contact information
Practice address
8050 HIGHWAY 72 W, MADISON, AL 35758-9567
(256) 830-1630
(256) 830-2206
Mailing address
PO BOX 8500, LOCKBOX 8531, PHILADELPHIA, PA 19178-8531
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
112669
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0133188
NCPDP PROVIDER IDENTIFICATION NUMBER
—
05
—
100003630
—
AL
Enumeration date
09/30/2006
Last updated
10/30/2009
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