Organization
JIMS PHARMACY LLC
Active
Other names
Jim's Pharmacy at the Lake
Organization subpart
No
Provider details
NPI number
Authorized official
JIM CLANTON (OWNER)
(205) 310-9278
Entity
Organization
Contact information
Practice address
6378 HIGHWAY 49 S, DADEVILLE, AL 36853-6727
(256) 373-3449
(256) 373-3359
Mailing address
6378 HIGHWAY 49 S, DADEVILLE, AL 36853-6727
(256) 373-3449
(256) 373-3359
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
114602
AL
3336C0004X
Compounding Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2158847
PK
—
Enumeration date
03/09/2016
Last updated
11/14/2020
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