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Organization

MALLETTE DRUG COMPANY INC

Active
Other names
MALLETTE DRUG COMPANY
Organization subpart
No

Provider details

NPI number
Authorized official
BOBBY SCOTT RPH (OWNER/PRES)
(334) 222-1141
Entity
Organization

Contact information

Practice address
837 S THREE NOTCH ST, ANDALUSIA, AL 36420-5321
(334) 222-1141
(334) 222-8361
Mailing address
PO BOX 327, ANDALUSIA, AL 36420-1205

Taxonomy

Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
333600000X
Pharmacy
3336C0003X
Community/Retail Pharmacy
Primary
106470
AL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0103779
NCPDP PROVIDER IDENTIFICATION NUMBER
05
100000373
AL
Enumeration date
11/07/2006
Last updated
02/11/2009
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