Organization
MOULTRIE PHARMACY AT CADDO LLC
Active
Other names
Moultrie Pharmacy at Caddo
Organization subpart
No
Provider details
NPI number
Authorized official
DR. BENJAMIN DAVID MOULTRIE PHARMD (OWNER)
(256) 566-3174
Entity
Organization
Contact information
Practice address
22747 AL HIGHWAY 24 STE D, MOULTON, AL 35650-8102
(256) 905-0030
(256) 905-0049
Mailing address
22747 AL HIGHWAY 24 STE D, MOULTON, AL 35650-8102
(256) 905-0030
(256) 905-0049
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
—
—
Other
Enumeration date
01/10/2022
Last updated
01/10/2022
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