Provider Demographics
NPI:1528379625
Name:B & G PHARMACY SERVICES
Entity Type:Organization
Organization Name:B & G PHARMACY SERVICES
Other - Org Name:CORNERSTONE FAMILY PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:VICE PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:GEORGE
Authorized Official - Middle Name:SCOTT
Authorized Official - Last Name:GODFREY
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:256-456-5850
Mailing Address - Street 1:851 GOODYEAR AVE
Mailing Address - Street 2:
Mailing Address - City:GADSDEN
Mailing Address - State:AL
Mailing Address - Zip Code:35903-1133
Mailing Address - Country:US
Mailing Address - Phone:256-456-5850
Mailing Address - Fax:256-467-3585
Practice Address - Street 1:851 GOODYEAR AVE
Practice Address - Street 2:
Practice Address - City:GADSDEN
Practice Address - State:AL
Practice Address - Zip Code:35903-1133
Practice Address - Country:US
Practice Address - Phone:256-456-5850
Practice Address - Fax:256-467-3585
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-06-23
Last Update Date:2020-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL1134013336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL113401OtherALABAMA STATE BOARD OF PHARMACY PERMIT