Organization
CORDOVA DRUG COMPANY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KENNETH SAMUEL GLOVER II RPH (OWNER)
(205) 648-9918
Entity
Organization
Contact information
Practice address
83 MAIN ST, CORDOVA, AL 35550-1414
(205) 483-7811
(205) 483-7821
Mailing address
83 MAIN ST, CORDOVA, AL 35550-1414
(205) 483-7811
(205) 483-7821
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
111584
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100000897
—
AL
Enumeration date
09/20/2006
Last updated
08/08/2008
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