Provider Demographics
NPI:1285789255
Name:EUTAW DRUG COMPANY
Entity type:Organization
Organization Name:EUTAW DRUG COMPANY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF PHARMACISTS
Authorized Official - Prefix:
Authorized Official - First Name:CECIL
Authorized Official - Middle Name:NORMAN
Authorized Official - Last Name:DURRETT
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:205-372-3346
Mailing Address - Street 1:PO BOX 390
Mailing Address - Street 2:
Mailing Address - City:EUTAW
Mailing Address - State:AL
Mailing Address - Zip Code:35462-0390
Mailing Address - Country:US
Mailing Address - Phone:205-372-3346
Mailing Address - Fax:205-372-0639
Practice Address - Street 1:202 PRAIRIE AVE
Practice Address - Street 2:
Practice Address - City:EUTAW
Practice Address - State:AL
Practice Address - Zip Code:35462-1174
Practice Address - Country:US
Practice Address - Phone:205-372-3346
Practice Address - Fax:205-372-0639
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-23
Last Update Date:2007-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL7662183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes183500000XPharmacy Service ProvidersPharmacistGroup - Single Specialty