Organization
THE PHARMACY BOOTHE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JEANNA SEWELL BOOTHE PHARMD (PRESIDENT)
(256) 461-6376
Entity
Organization
Contact information
Practice address
3825 SULLIVAN ST, SUITE 2, MADISON, AL 35758-1740
(256) 461-6376
(256) 461-6334
Mailing address
3825 SULLIVAN ST, SUITE 2, MADISON, AL 35758-1740
(256) 461-6376
(256) 461-6334
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
112348
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0132009
NCPDP
—
01
—
112348
STATE LICENSE
AL
01
—
515-19983
BCBS DME PROVIDER
AL
Enumeration date
06/10/2006
Last updated
03/07/2023
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