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1629120894
SAMUEL MARION COSTELLO
DECATUR, AL
NPI
1629120894
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
183500000X Pharmacist
(Licence: AL 7105)
Enumeration Date
2007-01-17
Last Update Date
2007-07-08
Business Address
SAMUEL MARION COSTELLO REG PHARMACIST
2422 DANVILLE RD SW STE J
DECATUR, AL 35603-4221
Phone number: 256-353-1121
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Mailing Address
SAMUEL MARION COSTELLO REG PHARMACIST
4405 AUTUMN LEAVES TRL SE
DECATUR, AL 35603-5340
Phone number: 125-635-3633
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