Provider Demographics
NPI:1346064375
Name:FAMILY PHARMACY OF LITTLEVILLE INC
Entity type:Organization
Organization Name:FAMILY PHARMACY OF LITTLEVILLE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHARMACIST
Authorized Official - Prefix:
Authorized Official - First Name:JEREMY
Authorized Official - Middle Name:HEATH
Authorized Official - Last Name:LANE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:256-332-5545
Mailing Address - Street 1:1369 B GEORGE WALLACE HWY
Mailing Address - Street 2:
Mailing Address - City:RUSSELLVILLE
Mailing Address - State:AL
Mailing Address - Zip Code:35654-3281
Mailing Address - Country:US
Mailing Address - Phone:256-332-4021
Mailing Address - Fax:256-332-4026
Practice Address - Street 1:1369 B GEORGE WALLACE HWY
Practice Address - Street 2:
Practice Address - City:RUSSELLVILLE
Practice Address - State:AL
Practice Address - Zip Code:35654-3281
Practice Address - Country:US
Practice Address - Phone:256-332-4021
Practice Address - Fax:256-332-4026
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-11-15
Last Update Date:2024-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336L0003XSuppliersPharmacyLong Term Care Pharmacy
No333600000XSuppliersPharmacy
No3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy