| NPI | 1942011663 |
|---|---|
| Former Legal Business Name | FORT PAYNE PHARMACY LLC |
| Entity Type | Organization |
| Authorized Contact | LEATRICIA LYNN BONNER Owner 256-845-3402 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0003X Pharmacy, Community/Retail Pharmacy |
| Enumeration Date | 2025-01-14 |
| Last Update Date | 2025-01-14 |