Organization
SHADY ACRES INC
Active
Other names
IV STAT INC
Organization subpart
No
Provider details
NPI number
Authorized official
BENJAMIN G MAIN SR. (MGR)
(334) 750-2103
Entity
Organization
Contact information
Practice address
302 PRAIRIE ST N, SUITE 3B, UNION SPRINGS, AL 36089-1417
(334) 738-2022
Mailing address
PO BOX 432, UNION SPRINGS, AL 36089-0432
(334) 738-2022
(334) 738-8050
Taxonomy
Speciality
Code
Description
License number
State
3336L0003X
Long Term Care Pharmacy
Primary
105493
AL
Other
Enumeration date
02/14/2007
Last updated
06/24/2008
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