Provider Demographics
NPI:1972956357
Name:BOONE AND DAVIS PHARMACIES, INC.
Entity Type:Organization
Organization Name:BOONE AND DAVIS PHARMACIES, INC.
Other - Org Name:CITY DRUGS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:LAMAR
Authorized Official - Last Name:BOONE
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:334-341-3466
Mailing Address - Street 1:PO BOX 480999
Mailing Address - Street 2:
Mailing Address - City:LINDEN
Mailing Address - State:AL
Mailing Address - Zip Code:36748-0999
Mailing Address - Country:US
Mailing Address - Phone:334-295-4270
Mailing Address - Fax:334-295-0141
Practice Address - Street 1:123 S JACKSON ST
Practice Address - Street 2:
Practice Address - City:GROVE HILL
Practice Address - State:AL
Practice Address - Zip Code:36451-3007
Practice Address - Country:US
Practice Address - Phone:251-275-3669
Practice Address - Fax:251-275-8190
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-07-20
Last Update Date:2016-07-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL1146443336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy