| NPI | 1659446458 |
|---|---|
| Doing Business As | CRESTLINE PHARMACY LTC |
| Entity Type | Organization |
| Authorized Contact | MATTHEW SCOTT LEACH Owner 205-871-0317 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336L0003X Pharmacy Long Term Care Pharmacy |
| Additional Taxonomies | 3336C0003X Pharmacy Community/Retail Pharmacy (Licence: AL 102890) |
| Enumeration Date | 2006-11-21 |
| Last Update Date | 2024-02-14 |