Provider Demographics
NPI:1922045301
Name:ODENVILLE DRUGS, INC
Entity Type:Organization
Organization Name:ODENVILLE DRUGS, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PHARMACISTS
Authorized Official - Prefix:MR
Authorized Official - First Name:CURTIS
Authorized Official - Middle Name:MARSHALL
Authorized Official - Last Name:EDDY
Authorized Official - Suffix:
Authorized Official - Credentials:PHARM D
Authorized Official - Phone:205-629-6303
Mailing Address - Street 1:140 COUNCIL DR
Mailing Address - Street 2:PO BOX 787
Mailing Address - City:ODENVILLE
Mailing Address - State:AL
Mailing Address - Zip Code:35120-4495
Mailing Address - Country:US
Mailing Address - Phone:205-629-6303
Mailing Address - Fax:205-629-6357
Practice Address - Street 1:140 COUNCIL DR
Practice Address - Street 2:
Practice Address - City:ODENVILLE
Practice Address - State:AL
Practice Address - Zip Code:35120-4495
Practice Address - Country:US
Practice Address - Phone:205-629-6303
Practice Address - Fax:205-629-6357
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-02
Last Update Date:2012-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL112071332B00000X, 333600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes333600000XSuppliersPharmacy
No332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL009932217Medicaid
AL0131134OtherNAPCP NUMBER
AL100003289Medicaid
AL5457430001Medicare NSC