Provider Demographics
NPI:1154481489
Name:C & L DRUG COMPANY OF CULLMAN INC.
Entity Type:Organization
Organization Name:C & L DRUG COMPANY OF CULLMAN INC.
Other - Org Name:HOSPITAL DISCOUNT PHARMACY CENTRAL
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PHARMACIST
Authorized Official - Prefix:MR
Authorized Official - First Name:REX
Authorized Official - Middle Name:E
Authorized Official - Last Name:SMITH
Authorized Official - Suffix:
Authorized Official - Credentials:RPH MANAGER
Authorized Official - Phone:256-734-6013
Mailing Address - Street 1:209 4TH AVE NE
Mailing Address - Street 2:
Mailing Address - City:CULLMAN
Mailing Address - State:AL
Mailing Address - Zip Code:35055-1904
Mailing Address - Country:US
Mailing Address - Phone:256-734-6013
Mailing Address - Fax:256-734-6458
Practice Address - Street 1:209 4TH AVE NE
Practice Address - Street 2:
Practice Address - City:CULLMAN
Practice Address - State:AL
Practice Address - Zip Code:35055-1904
Practice Address - Country:US
Practice Address - Phone:256-734-6013
Practice Address - Fax:256-734-6458
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-08
Last Update Date:2012-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL8118332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL000054697Medicaid
AL0547570001Medicare NSC