Provider Demographics
NPI:1104864669
Name:CURTIS M EDDY INC
Entity Type:Organization
Organization Name:CURTIS M EDDY INC
Other - Org Name:MOODY DRUGS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER PHARMACIST
Authorized Official - Prefix:
Authorized Official - First Name:CURTIS
Authorized Official - Middle Name:
Authorized Official - Last Name:EDDY
Authorized Official - Suffix:
Authorized Official - Credentials:PHARM D
Authorized Official - Phone:205-640-1500
Mailing Address - Street 1:PO BOX 787
Mailing Address - Street 2:
Mailing Address - City:ODENVILLE
Mailing Address - State:AL
Mailing Address - Zip Code:35120-0787
Mailing Address - Country:US
Mailing Address - Phone:205-629-6303
Mailing Address - Fax:205-629-7450
Practice Address - Street 1:2200 VILLAGE DR
Practice Address - Street 2:
Practice Address - City:MOODY
Practice Address - State:AL
Practice Address - Zip Code:35004-3241
Practice Address - Country:US
Practice Address - Phone:205-640-1500
Practice Address - Fax:205-640-5525
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-04
Last Update Date:2014-12-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
333600000X
AL1127323336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No333600000XSuppliersPharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
1995723OtherPK
AL100003678Medicaid