Edmondson Drug Company Inc

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

111500 Issued in AL

Legal business name

EDMONDSON DRUG COMPANY INC

Doing business as

Lakeside Pharmacy

Practice address

445 Al Highway 69 S Ste D
Hanceville, AL 35077-3437

Phone

(256) 287-9099

Fax

(256) 287-2817

NPI assigned

Jun 11, 2006

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Charlotte Edmondson, PHARMDNPI 1932285301

Title

Owner and Pharmacist

Phone

(256) 287-9099

Specialties & licenses 3

Addresses

Other identifiers 2

Other names 1

• LAKESIDE PHARMACY Doing business as

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Charlotte M Edmondson, PHARM D

  • Pharmacist
  • Hanceville, AL
  • NPI 1932285301
  NPD (past) Authorized official
• Rachel Roberts Oakes

  • Pharmacist
  • Hanceville, AL
  • NPI 1952943292
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1149984000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1439942400000",
    "number": "1215979885",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 789",
            "city": "CULLMAN",
            "state": "AL",
            "postal_code": "350560789"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "445 AL HIGHWAY 69 S STE D",
            "city": "HANCEVILLE",
            "state": "AL",
            "postal_code": "350773437",
            "telephone_number": "256-287-9099",
            "fax_number": "256-287-2817"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EDMONDSON DRUG COMPANY INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-11",
        "last_updated": "2015-08-19",
        "status": "A",
        "authorized_official_last_name": "EDMONDSON",
        "authorized_official_first_name": "CHARLOTTE",
        "authorized_official_title_or_position": "OWNER AND PHARMACIST",
        "authorized_official_telephone_number": "256-287-9099",
        "authorized_official_credential": "PHARMD"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "AL",
            "license": "111500",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100003509",
            "state": "AL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "1995236",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "LAKESIDE PHARMACY",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Falyn Cole Cochran
• Cullman Regional Medical Center (Hanceville Health Center)
• Dodge City Medical Clinic, Inc.
• Dube Family Dentistry Inc
• Peter Wade Dube, DMD
• Charlotte M Edmondson, PHARM D
• Ashley Frey, CRNP
• Eileen M Gallagher, DO
• Zachary Blake Gentry
• Whitney Lauren Greene, M.S. CCC-SLP

• Community/Retail Pharmacy in Hanceville, AL
• Providers in Hanceville, AL by specialty
• Community/Retail Pharmacy in Alabama

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 19, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.