Organization
CITRONELLE DRUG CO INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ROBERT WAYNE JEFFUS RPH (PRESIDENT OWNER PHARMACIST)
(251) 866-5522
Entity
Organization
Contact information
Practice address
19240 MOBILE ST, CITRONELLE, AL 36522
(251) 866-5522
(251) 866-2335
Mailing address
PO BOX 386, CITRONELLE, AL 36522-0386
(251) 866-5522
(251) 866-2335
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
10811
AL
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
3336C0003X
Community/Retail Pharmacy
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100000334
—
AL
Enumeration date
03/05/2007
Last updated
02/22/2010
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