Provider Demographics
NPI:1194779330
Name:B&G DRUG CO. INC
Entity type:Organization
Organization Name:B&G DRUG CO. INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/PHARMACIST
Authorized Official - Prefix:MR
Authorized Official - First Name:CHRISTOPHER
Authorized Official - Middle Name:DAVID
Authorized Official - Last Name:HENDERSON
Authorized Official - Suffix:
Authorized Official - Credentials:PHRAMD
Authorized Official - Phone:256-352-4371
Mailing Address - Street 1:PO BOX 288
Mailing Address - Street 2:
Mailing Address - City:HANCEVILLE
Mailing Address - State:AL
Mailing Address - Zip Code:35077-0288
Mailing Address - Country:US
Mailing Address - Phone:256-352-4371
Mailing Address - Fax:256-352-2014
Practice Address - Street 1:804 MAIN ST NE
Practice Address - Street 2:
Practice Address - City:HANCEVILLE
Practice Address - State:AL
Practice Address - Zip Code:35077-5461
Practice Address - Country:US
Practice Address - Phone:256-352-4371
Practice Address - Fax:256-352-2014
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-20
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL22523332B00000X
AL1118983336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Not Answered3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL4149800001Medicare ID - Type Unspecified