Provider Demographics
NPI:1336135367
Name:WOODSTOCK DRUG INC
Entity Type:Organization
Organization Name:WOODSTOCK DRUG INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:F
Authorized Official - Last Name:ROOKER
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:205-938-9221
Mailing Address - Street 1:PO BOX 280
Mailing Address - Street 2:
Mailing Address - City:WOODSTOCK
Mailing Address - State:AL
Mailing Address - Zip Code:35188-0280
Mailing Address - Country:US
Mailing Address - Phone:205-938-9221
Mailing Address - Fax:205-938-9290
Practice Address - Street 1:28891 HIGHWAY 5
Practice Address - Street 2:
Practice Address - City:WOODSTOCK
Practice Address - State:AL
Practice Address - Zip Code:35188-3614
Practice Address - Country:US
Practice Address - Phone:205-938-9221
Practice Address - Fax:205-938-9290
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-09-26
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL110245183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes183500000XPharmacy Service ProvidersPharmacistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
0122351OtherNABP