Cloverland Drug, Inc

Primary specialty

PharmacyTaxonomy code 333600000X

License

104085 Issued in AL

Legal business name

CLOVERLAND DRUG, INC

Doing business as

Fountain City Pharmacy

Practice address

105 N Memorial Dr
Prattville, AL 36067-3332

Phone

(334) 365-3327

Fax

(334) 365-3316

NPI assigned

Nov 3, 2006

Last updated

Dec 21, 2015By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

David Saalwaechter, RPH

Title

President

Phone

(334) 322-2927

Specialties & licenses 4

Addresses

Other identifiers 2

Other names 1

• Fountain City Pharmacy Doing business as

Tax ID family

Cloverland Drug Inc2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Cloverland Drugs, Inc

  • Compounding Pharmacy
  • Montgomery, AL
  • NPI 1144578261
  NPD tax ID

Locations

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

{
    "created_epoch": "1162512000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1450656000000",
    "number": "1316026164",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 240817",
            "city": "MONTGOMERY",
            "state": "AL",
            "postal_code": "361240817",
            "telephone_number": "334-386-2742",
            "fax_number": "334-386-2745"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "105 N MEMORIAL DR",
            "city": "PRATTVILLE",
            "state": "AL",
            "postal_code": "360673332",
            "telephone_number": "334-365-3327",
            "fax_number": "334-365-3316"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CLOVERLAND DRUG, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-03",
        "last_updated": "2015-12-21",
        "status": "A",
        "authorized_official_last_name": "SAALWAECHTER",
        "authorized_official_first_name": "DAVID",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "334-322-2927",
        "authorized_official_credential": "RPH"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": "AL",
            "license": "104085",
            "primary": true
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "3336M0002X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Mail Order Pharmacy",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0004X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Compounding Pharmacy",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2143927",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "156110",
            "state": "AL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Fountain City Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Christian Garrett Cleckler, PHARMD
• Jenifer Howell Clements, RDN
• Abigail Grace Cleveland, RBT
• Wade Glenn Clingan, D.C.
• Charles Garrison Cloutier, MD
• Molly Cobb, RN
• Lori R Colley
• Monica Colotario Pickett, PTA
• Jenna Connell
• Adia Conniff

• Pharmacy in Prattville, AL
• Providers in Prattville, AL by specialty
• Pharmacy in Alabama

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 21, 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.