Provider Demographics
NPI:1124693999
Name:DECATUR FAMILY PHARMACY
Entity type:Organization
Organization Name:DECATUR FAMILY PHARMACY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PIC/MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:ALMEDA
Authorized Official - Middle Name:
Authorized Official - Last Name:BORDEN
Authorized Official - Suffix:
Authorized Official - Credentials:PHARMD
Authorized Official - Phone:256-822-2176
Mailing Address - Street 1:2828 HIGHWAY 31 S
Mailing Address - Street 2:
Mailing Address - City:DECATUR
Mailing Address - State:AL
Mailing Address - Zip Code:35603-1538
Mailing Address - Country:US
Mailing Address - Phone:256-822-2176
Mailing Address - Fax:256-822-2179
Practice Address - Street 1:2828 HIGHWAY 31 S
Practice Address - Street 2:
Practice Address - City:DECATUR
Practice Address - State:AL
Practice Address - Zip Code:35603-1538
Practice Address - Country:US
Practice Address - Phone:256-822-2176
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-05-25
Last Update Date:2021-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy