Provider Demographics
NPI:1477667376
Name:PHARMACY INC
Entity Type:Organization
Organization Name:PHARMACY INC
Other - Org Name:ALACO DISCOUNT PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:THOMAS
Authorized Official - Middle Name:C
Authorized Official - Last Name:MORGAN
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:205-274-2194
Mailing Address - Street 1:102 J D SMITH DRIVE
Mailing Address - Street 2:ALACO WAREHOUSE BUSINESS OFFICE
Mailing Address - City:ATTALLA
Mailing Address - State:AL
Mailing Address - Zip Code:35954-3350
Mailing Address - Country:US
Mailing Address - Phone:256-538-5697
Mailing Address - Fax:256-538-0239
Practice Address - Street 1:27550 STATE HWY 75
Practice Address - Street 2:SUITE #107
Practice Address - City:ONEONTA
Practice Address - State:AL
Practice Address - Zip Code:35121
Practice Address - Country:US
Practice Address - Phone:205-274-2194
Practice Address - Fax:205-274-2197
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-18
Last Update Date:2019-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL101055333600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes333600000XSuppliersPharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL100001173Medicaid
AL0108868OtherNABP NUMBER