Provider Information for 1457539710
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PARKS PHARMACY
Other Names:Doing Business As:PARKS PHARMACYOrganization Subpart: NO
NPI: 1457539710
Last Updated: 2020-07-03
Certification Date: 2020-07-03
Certification Date: 2020-07-03
Details
Name | Value | ||||||||||||
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NPI | 1457539710 | ||||||||||||
Enumeration Date | 2008-02-08 | ||||||||||||
NPI Type | NPI-2 Organization | ||||||||||||
Status | Active | ||||||||||||
Authorized Official Information | Name: LA SONYA GLOVER Title: President Phone: 3347991489 | ||||||||||||
Mailing Address | PO BOX 250310 MONTGOMERY, AL 36125-0310 United States Phone: 334-799-1489 | Fax:334-375-4723 | ||||||||||||
Primary Practice Address | 1323 MULBERRY ST STE A MONTGOMERY, AL 36106-1545 United States Phone: 334-264-1416 | Fax:334-264-1426 | ||||||||||||
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