Provider Demographics
NPI:1396898250
Name:BENDALL'S PHARMACY INC.
Entity type:Organization
Organization Name:BENDALL'S PHARMACY INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:NICOLE
Authorized Official - Middle Name:B
Authorized Official - Last Name:ROBERTSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:256-962-6762
Mailing Address - Street 1:1316-A STRATFORD RD SE
Mailing Address - Street 2:
Mailing Address - City:DECATUR
Mailing Address - State:AL
Mailing Address - Zip Code:35601-6036
Mailing Address - Country:US
Mailing Address - Phone:256-962-6762
Mailing Address - Fax:256-353-2093
Practice Address - Street 1:1316-A STRATFORD RD SE
Practice Address - Street 2:
Practice Address - City:DECATUR
Practice Address - State:AL
Practice Address - Zip Code:35601-6036
Practice Address - Country:US
Practice Address - Phone:256-353-2021
Practice Address - Fax:256-353-2093
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-22
Last Update Date:2023-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL111706183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes183500000XPharmacy Service ProvidersPharmacistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL100001615Medicaid
AL100001615Medicaid