Provider Demographics
NPI:1326874645
Name:MAIN DRUG INC
Entity type:Organization
Organization Name:MAIN DRUG INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PHARMACIST IN CHARGE
Authorized Official - Prefix:
Authorized Official - First Name:THOMAS
Authorized Official - Middle Name:ALLEN
Authorized Official - Last Name:MAIN
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:334-738-2020
Mailing Address - Street 1:PO BOX 640700
Mailing Address - Street 2:
Mailing Address - City:PIKE ROAD
Mailing Address - State:AL
Mailing Address - Zip Code:36064-0700
Mailing Address - Country:US
Mailing Address - Phone:334-738-2020
Mailing Address - Fax:877-865-8153
Practice Address - Street 1:302 PRAIRIE ST N
Practice Address - Street 2:
Practice Address - City:UNION SPRINGS
Practice Address - State:AL
Practice Address - Zip Code:36089-1417
Practice Address - Country:US
Practice Address - Phone:334-738-2020
Practice Address - Fax:877-865-8153
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-09-12
Last Update Date:2024-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336L0003XSuppliersPharmacyLong Term Care Pharmacy