Provider Demographics
NPI:1942345756
Name:CITIZEN EXPRESS PHARMACY
Entity type:Organization
Organization Name:CITIZEN EXPRESS PHARMACY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:DELMOUS
Authorized Official - Middle Name:
Authorized Official - Last Name:VANCE
Authorized Official - Suffix:III
Authorized Official - Credentials:
Authorized Official - Phone:205-323-8374
Mailing Address - Street 1:1513 5TH AVE N
Mailing Address - Street 2:
Mailing Address - City:BIRMINGHAM
Mailing Address - State:AL
Mailing Address - Zip Code:35203-1840
Mailing Address - Country:US
Mailing Address - Phone:205-323-8374
Mailing Address - Fax:205-323-8375
Practice Address - Street 1:1513 5TH AVE N
Practice Address - Street 2:
Practice Address - City:BIRMINGHAM
Practice Address - State:AL
Practice Address - Zip Code:35203-1840
Practice Address - Country:US
Practice Address - Phone:205-323-8374
Practice Address - Fax:205-323-8375
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-20
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL16637333600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes333600000XSuppliersPharmacy