Organization
EVERGREEN DISCOUNT PHARMACY, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
RUSSELL SHELDT (PRESIDENT/PHARMACY MANAGER)
(850) 587-4008
Entity
Organization
Contact information
Practice address
310 W FRONT ST, EVERGREEN, AL 36401-2837
(251) 578-5061
Mailing address
310 W FRONT ST, EVERGREEN, AL 36401-2837
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
113781
AL
Other
Enumeration date
07/18/2011
Last updated
11/15/2011
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