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Contact Information

SERVICE DRUG STORE INC
5341 BROWN ST.
GRACEVILLE, FL32440
 Phone: 850-263-3257
 Fax: 850-263-3220
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Community/Retail Pharmacy

3336C0003X 58 Medical Supply Company with Pharmacist
Indicates primary specialty

NPI Profile & details for SERVICE DRUG STORE INC

NPI Number 1417148396
LBN Legal business name SERVICE DRUG STORE INC
Authorized official STACY COOK - (OWNER/PRESIDENT)
Entity Organization
Organization subpart 1 No
Enumeration date 08/06/2007
Last updated 11/15/2013 - About 13 years ago
Identifiers
FL License # PH25848
FL Medicaid 100454900
FL Medicaid 100454901
FL Other 1039153 NABP
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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