Healthcare Provider Details

I. General information

NPI: 1841360922
Provider Name (Legal Business Name): PAYLESS DRUG
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/08/2006
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

50 E FLAMING GORGE WAY
GREEN RIVER WY
82935-4210
US

IV. Provider business mailing address

50 E FLAMING GORGE WAY
GREEN RIVER WY
82935-4210
US

V. Phone/Fax

Practice location:
  • Phone: 307-875-2435
  • Fax: 307-875-8850
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code333600000X
TaxonomyPharmacy
License Number04000017
License Number StateWY
# 2
Primary TaxonomyN
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number
License Number State

VIII. Authorized Official

Name: LARRY HILL
Title or Position: OWNER
Credential:
Phone: 307-875-2435