Provider Demographics
NPI:1467701706
Name:DARBYS VILLAGE PHARMACY INC
Entity Type:Organization
Organization Name:DARBYS VILLAGE PHARMACY INC
Other - Org Name:DARBY'S MEDICAL CENTER PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PHARMACIST/SECRETARY
Authorized Official - Prefix:
Authorized Official - First Name:LAURA
Authorized Official - Middle Name:
Authorized Official - Last Name:DARBY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:334-582-3784
Mailing Address - Street 1:822A S THREE NOTCH ST
Mailing Address - Street 2:
Mailing Address - City:ANDALUSIA
Mailing Address - State:AL
Mailing Address - Zip Code:36420-5310
Mailing Address - Country:US
Mailing Address - Phone:334-582-3784
Mailing Address - Fax:334-582-3785
Practice Address - Street 1:822A S THREE NOTCH ST
Practice Address - Street 2:
Practice Address - City:ANDALUSIA
Practice Address - State:AL
Practice Address - Zip Code:36420-5310
Practice Address - Country:US
Practice Address - Phone:334-582-3784
Practice Address - Fax:334-582-3785
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-08-31
Last Update Date:2017-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
333600000X
AL1139533336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No333600000XSuppliersPharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL141288Medicaid
2136604OtherPK