Provider Demographics
NPI:1902162548
Name:APOTHECARY SALES INC
Entity Type:Organization
Organization Name:APOTHECARY SALES INC
Other - Org Name:SOUTHERN COMPOUNDING
Other - Org Type:Doing Business As
Authorized Official - Title/Position:SUPERVISING PHARMACIST
Authorized Official - Prefix:
Authorized Official - First Name:ALMEDA
Authorized Official - Middle Name:
Authorized Official - Last Name:BORDEN
Authorized Official - Suffix:
Authorized Official - Credentials:PHARM D
Authorized Official - Phone:256-340-3700
Mailing Address - Street 1:PO BOX 5694
Mailing Address - Street 2:
Mailing Address - City:DECATUR
Mailing Address - State:AL
Mailing Address - Zip Code:35601-0694
Mailing Address - Country:US
Mailing Address - Phone:256-340-3700
Mailing Address - Fax:256-340-3730
Practice Address - Street 1:3220 HIGHWAY 31 S STE A2
Practice Address - Street 2:
Practice Address - City:DECATUR
Practice Address - State:AL
Practice Address - Zip Code:35603-1731
Practice Address - Country:US
Practice Address - Phone:256-340-3700
Practice Address - Fax:256-340-3730
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-04-09
Last Update Date:2015-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX27640333600000X
AL113687333600000X
MS08975/7.1333600000X
FLPH 256033336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes333600000XSuppliersPharmacy
No3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
2137455OtherPK