Provider Demographics
NPI:1588770952
Name:BRUNOS INC
Entity type:Organization
Organization Name:BRUNOS INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PHARMACY MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:LISA
Authorized Official - Middle Name:
Authorized Official - Last Name:PLOWMAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:205-339-6756
Mailing Address - Street 1:400 MCFARLAND BLVD WEST NORTHPORT PLAZA
Mailing Address - Street 2:
Mailing Address - City:NORTHPORT
Mailing Address - State:AL
Mailing Address - Zip Code:35476
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:400 MCFARLAND BLVD WEST NORTHPORT PLAZA
Practice Address - Street 2:
Practice Address - City:NORTHPORT
Practice Address - State:AL
Practice Address - Zip Code:35476
Practice Address - Country:US
Practice Address - Phone:205-339-6756
Practice Address - Fax:205-339-9093
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-21
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL111618333600000X
3336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered333600000XSuppliersPharmacy
Not Answered3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
0129533OtherOTHER ID NUMBER-COMMERCIAL NUMBER
0129533OtherOTHER ID NUMBER-COMMERCIAL NUMBER