Healthcare Provider Details

I. General information

NPI: 1164578514
Provider Name (Legal Business Name): PAYLESS PHARMACY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/26/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

29930 ARDMORE AVE
ARDMORE AL
35739-7450
US

IV. Provider business mailing address

29930 ARDMORE AVE
ARDMORE AL
35739-7450
US

V. Phone/Fax

Practice location:
  • Phone: 256-423-8989
  • Fax: 256-423-8990
Mailing address:
  • Phone: 256-423-8989
  • Fax: 256-423-8990

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number110617
License Number StateAL

VIII. Authorized Official

Name: MR. JASON EDWIN MURPH
Title or Position: CHIEF PHARMACIST
Credential: RPH
Phone: 256-423-8989