Provider Demographics
NPI:1164668323
Name:SOUTHERN FAMILY MARKETS, LLC
Entity Type:Organization
Organization Name:SOUTHERN FAMILY MARKETS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF PHARMACY
Authorized Official - Prefix:MR
Authorized Official - First Name:MARK
Authorized Official - Middle Name:R
Authorized Official - Last Name:TOW
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:205-912-4934
Mailing Address - Street 1:800 LAKESHORE PKWY
Mailing Address - Street 2:
Mailing Address - City:BIRMINGHAM
Mailing Address - State:AL
Mailing Address - Zip Code:35211-4447
Mailing Address - Country:US
Mailing Address - Phone:205-912-4934
Mailing Address - Fax:205-912-4919
Practice Address - Street 1:800 LAKESHORE PKWY
Practice Address - Street 2:
Practice Address - City:BIRMINGHAM
Practice Address - State:AL
Practice Address - Zip Code:35211-4447
Practice Address - Country:US
Practice Address - Phone:205-912-4934
Practice Address - Fax:205-912-4919
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-12-18
Last Update Date:2008-12-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy