Provider Demographics
NPI:1073170775
Name:VILLAGE DRUG CO. LLC
Entity Type:Organization
Organization Name:VILLAGE DRUG CO. LLC
Other - Org Name:VILLAGE DRUG CO.
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER/PIC
Authorized Official - Prefix:DR
Authorized Official - First Name:MATTHEW
Authorized Official - Middle Name:
Authorized Official - Last Name:ZAUCHIN
Authorized Official - Suffix:
Authorized Official - Credentials:PHARMD
Authorized Official - Phone:205-713-8393
Mailing Address - Street 1:300 CARLOW LN
Mailing Address - Street 2:STE 116
Mailing Address - City:BIRMINGHAM
Mailing Address - State:AL
Mailing Address - Zip Code:35217
Mailing Address - Country:US
Mailing Address - Phone:205-410-5528
Mailing Address - Fax:205-875-6032
Practice Address - Street 1:300 CARLOW LN
Practice Address - Street 2:STE 116
Practice Address - City:BIRMINGHAM
Practice Address - State:AL
Practice Address - Zip Code:35217
Practice Address - Country:US
Practice Address - Phone:205-410-5528
Practice Address - Fax:205-875-6032
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-05-29
Last Update Date:2021-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL1073170775Medicaid