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NPI Code Detail

MEDICARE: THE DRUG STORE CO INC

MEDICARE: THE DRUG STORE CO INC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1332B00000XDurable Medical Equipment & Medical Supplies
2333600000XPharmacy
33336C0003XCommunity/Retail Pharmacy110332AL

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
31989272OTHERPK

General Provider Information

NPI Number : 1497797062
Entity Type Code : Organization
Provider Name (Legal Business Name) : THE DRUG STORE CO INC
Provider Business Mailing Address
First Line : PO BOX 1246
Second Line :
City : LIVINGSTON
State : AL
Zip : 35470-1246
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 583 4TH AVE
Second Line :
City : YORK
State : AL
Zip : 36925-2008
Country : US
Telephone Number : 205-392-5201
Fax Number : 205-392-7006
Authorized Official
Title or Position : PIC OWNER
Name : LEE DAVIS
Credential :
Telephone Number : 205-392-5201
Provider Enumeration Date : 06/11/2006
Last Update Date : 04/15/2020

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Directions to “THE DRUG STORE CO INC ” Practice Location

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