Provider Demographics
NPI:1245578251
Name:TUSCALOOSA DRUG 5 POINTS, LLC
Entity Type:Organization
Organization Name:TUSCALOOSA DRUG 5 POINTS, LLC
Other - Org Name:TUSCALOOSA DRUG 5 POINTS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:BRIAN
Authorized Official - Middle Name:DANIEL
Authorized Official - Last Name:SWEATT
Authorized Official - Suffix:
Authorized Official - Credentials:PHARMD
Authorized Official - Phone:205-270-2000
Mailing Address - Street 1:4301 VETERANS MEMORIAL PKWY
Mailing Address - Street 2:
Mailing Address - City:TUSCALOOSA
Mailing Address - State:AL
Mailing Address - Zip Code:35404-5185
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:4301 VETERANS MEMORIAL PKWY
Practice Address - Street 2:
Practice Address - City:TUSCALOOSA
Practice Address - State:AL
Practice Address - Zip Code:35404-5185
Practice Address - Country:US
Practice Address - Phone:205-792-7264
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:TUSCALOOSA DRUG COMPANY, INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2013-01-25
Last Update Date:2013-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL1140403336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL114040OtherALABAMA STATE BOARD OF PHARMACY