Provider Demographics
NPI:1194260331
Name:THE GENERIC PHARMACY - DOTHAN
Entity type:Organization
Organization Name:THE GENERIC PHARMACY - DOTHAN
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PHARMACIST
Authorized Official - Prefix:MR
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:ALLEN
Authorized Official - Last Name:STRICKLAND
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:334-798-1827
Mailing Address - Street 1:2115 E MAIN ST
Mailing Address - Street 2:SUITE #4
Mailing Address - City:DOTHAN
Mailing Address - State:AL
Mailing Address - Zip Code:36301-3044
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:2115 E MAIN ST
Practice Address - Street 2:SUITE #4
Practice Address - City:DOTHAN
Practice Address - State:AL
Practice Address - Zip Code:36301-3044
Practice Address - Country:US
Practice Address - Phone:334-798-1827
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-12-26
Last Update Date:2016-12-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL12107183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes183500000XPharmacy Service ProvidersPharmacistGroup - Single Specialty