Provider Demographics
NPI:1013783943
Name:OUR TOWN PHARMACY, LLC
Entity Type:Organization
Organization Name:OUR TOWN PHARMACY, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHARMACIST/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ASHLEY
Authorized Official - Middle Name:PATE
Authorized Official - Last Name:JOHNSON
Authorized Official - Suffix:
Authorized Official - Credentials:PHARM D
Authorized Official - Phone:256-449-9416
Mailing Address - Street 1:PO BOX 854
Mailing Address - Street 2:
Mailing Address - City:WEDOWEE
Mailing Address - State:AL
Mailing Address - Zip Code:36278-0854
Mailing Address - Country:US
Mailing Address - Phone:256-357-0076
Mailing Address - Fax:256-357-2564
Practice Address - Street 1:100 OLD HIGHWAY 431
Practice Address - Street 2:
Practice Address - City:WEDOWEE
Practice Address - State:AL
Practice Address - Zip Code:36278-3627
Practice Address - Country:US
Practice Address - Phone:256-357-0076
Practice Address - Fax:256-357-2564
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-12-01
Last Update Date:2023-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No332B00000XSuppliersDurable Medical Equipment & Medical Supplies