Provider Demographics
NPI:1689607624
Name:FOSTER DRUG CO INC
Entity Type:Organization
Organization Name:FOSTER DRUG CO INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER, PIC, AO
Authorized Official - Prefix:
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:
Authorized Official - Last Name:CARPENTER
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:334-548-2125
Mailing Address - Street 1:PO BOX 366
Mailing Address - Street 2:
Mailing Address - City:HAYNEVILLE
Mailing Address - State:AL
Mailing Address - Zip Code:36040-0366
Mailing Address - Country:US
Mailing Address - Phone:334-548-2125
Mailing Address - Fax:334-548-2126
Practice Address - Street 1:12 LAFAYETTE ST
Practice Address - Street 2:
Practice Address - City:HAYNEVILLE
Practice Address - State:AL
Practice Address - Zip Code:36040-2089
Practice Address - Country:US
Practice Address - Phone:334-548-2125
Practice Address - Fax:334-548-2126
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-09
Last Update Date:2018-01-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
333600000X
AL1040753336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No333600000XSuppliersPharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
1988742OtherPK
AL100001924Medicaid
AL009939290Medicaid
AL100001924Medicaid