Organization
PCM PHARMACY
Active
Other names
PROFESSIONAL CUSTOMIZED MEDICATIONS
Organization subpart
No
Provider details
NPI number
Authorized official
WILLIAM WOOD RPH (MGR MEMBER)
(256) 757-1956
Entity
Organization
Contact information
Practice address
1621 HIGHWAY 72, KILLEN, AL 35645-9142
(256) 757-1956
(256) 757-1936
Mailing address
PO BOX 99, KILLEN, AL 35645-0099
(256) 757-1956
(256) 757-1936
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
—
—
3336S0011X
Specialty Pharmacy
Primary
111538
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0129191
NCPDP PROVIDER IDENTIFICATION NUMBER
—
05
—
100003101
—
AL
Enumeration date
07/30/2006
Last updated
07/16/2012
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