Provider Demographics
NPI:1265503825
Name:NORTHCUTTS DRUG COMPANY INC
Entity Type:Organization
Organization Name:NORTHCUTTS DRUG COMPANY INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:CLARENCE
Authorized Official - Middle Name:GLENN
Authorized Official - Last Name:NORTHCUTT
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:334-793-9538
Mailing Address - Street 1:PO BOX 219
Mailing Address - Street 2:
Mailing Address - City:DOTHAN
Mailing Address - State:AL
Mailing Address - Zip Code:36302-0219
Mailing Address - Country:US
Mailing Address - Phone:334-793-9538
Mailing Address - Fax:334-677-0898
Practice Address - Street 1:1774 W MAIN ST
Practice Address - Street 2:
Practice Address - City:DOTHAN
Practice Address - State:AL
Practice Address - Zip Code:36301-1318
Practice Address - Country:US
Practice Address - Phone:334-793-9538
Practice Address - Fax:334-677-0898
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-13
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL5454183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes183500000XPharmacy Service ProvidersPharmacistGroup - Single Specialty