Provider Demographics
NPI:1467534578
Name:WENDELL B. QUALLS
Entity Type:Organization
Organization Name:WENDELL B. QUALLS
Other - Org Name:OHATCHEE DISCOUNT DRUGS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PHARMACIST OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:WENDELL
Authorized Official - Middle Name:B
Authorized Official - Last Name:QUALLS
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:256-892-0653
Mailing Address - Street 1:7814 AL HIGHWAY 77
Mailing Address - Street 2:
Mailing Address - City:OHATCHEE
Mailing Address - State:AL
Mailing Address - Zip Code:36271-7836
Mailing Address - Country:US
Mailing Address - Phone:256-892-0653
Mailing Address - Fax:256-892-4670
Practice Address - Street 1:7814 AL HIGHWAY 77
Practice Address - Street 2:
Practice Address - City:OHATCHEE
Practice Address - State:AL
Practice Address - Zip Code:36271-7836
Practice Address - Country:US
Practice Address - Phone:256-892-0653
Practice Address - Fax:256-892-4670
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-19
Last Update Date:2008-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL107290183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes183500000XPharmacy Service ProvidersPharmacistGroup - Single Specialty