| NPI | 1841206570 |
|---|---|
| Doing Business As | DALLAS AVENUE PHARMACY |
| Entity Type | Organization |
| Authorized Contact | TIMOTHY L GIBBS President 334-872-3255 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0003X Pharmacy, Community/Retail Pharmacy (Licence: AL 103015) |
| Additional Taxonomies | 332B00000X Durable Medical Equipment & Medical Supplies |
| Enumeration Date | 2006-08-01 |
| Last Update Date | 2023-03-23 |