Provider Demographics
NPI:1790143196
Name:WAKEFIELD'S PHARMACY, INC
Entity Type:Organization
Organization Name:WAKEFIELD'S PHARMACY, INC
Other - Org Name:WAKEFIELD'S PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER/PIC
Authorized Official - Prefix:MRS
Authorized Official - First Name:KATIE
Authorized Official - Middle Name:
Authorized Official - Last Name:WAKEFIELD
Authorized Official - Suffix:
Authorized Official - Credentials:PHARM D
Authorized Official - Phone:205-487-4199
Mailing Address - Street 1:PO BOX 1077
Mailing Address - Street 2:
Mailing Address - City:WINFIELD
Mailing Address - State:AL
Mailing Address - Zip Code:35594-1077
Mailing Address - Country:US
Mailing Address - Phone:205-487-4199
Mailing Address - Fax:205-487-6009
Practice Address - Street 1:145 STATE HIGHWAY 253
Practice Address - Street 2:SUITE C
Practice Address - City:WINFIELD
Practice Address - State:AL
Practice Address - Zip Code:35594-5364
Practice Address - Country:US
Practice Address - Phone:205-487-4199
Practice Address - Fax:205-487-6009
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-02-01
Last Update Date:2016-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy