Provider Demographics
NPI:1023026168
Name:DUNLAP DRUG CO INC
Entity Type:Organization
Organization Name:DUNLAP DRUG CO INC
Other - Org Name:FOWLER PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:VICE PRESIDENT OWNER PHARMACIST
Authorized Official - Prefix:MR
Authorized Official - First Name:TOMMIE
Authorized Official - Middle Name:LINDEL
Authorized Official - Last Name:DUNLAP
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:256-773-5421
Mailing Address - Street 1:302 PINE ST NW
Mailing Address - Street 2:
Mailing Address - City:HARTSELLE
Mailing Address - State:AL
Mailing Address - Zip Code:35640-2316
Mailing Address - Country:US
Mailing Address - Phone:256-773-5421
Mailing Address - Fax:256-773-8488
Practice Address - Street 1:302 PINE ST NW
Practice Address - Street 2:
Practice Address - City:HARTSELLE
Practice Address - State:AL
Practice Address - Zip Code:35640-2316
Practice Address - Country:US
Practice Address - Phone:256-773-5421
Practice Address - Fax:256-773-8488
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-04
Last Update Date:2007-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
332B00000X
AL1033363336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
No3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL54683Medicaid
AL0280550001Medicare NSC
AL54683Medicaid