Provider Demographics
NPI:1164578514
Name:PAYLESS PHARMACY
Entity Type:Organization
Organization Name:PAYLESS PHARMACY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF PHARMACIST
Authorized Official - Prefix:MR
Authorized Official - First Name:JASON
Authorized Official - Middle Name:EDWIN
Authorized Official - Last Name:MURPH
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:256-423-8989
Mailing Address - Street 1:29930 ARDMORE AVE
Mailing Address - Street 2:
Mailing Address - City:ARDMORE
Mailing Address - State:AL
Mailing Address - Zip Code:35739-7450
Mailing Address - Country:US
Mailing Address - Phone:256-423-8989
Mailing Address - Fax:256-423-8990
Practice Address - Street 1:29930 ARDMORE AVE
Practice Address - Street 2:
Practice Address - City:ARDMORE
Practice Address - State:AL
Practice Address - Zip Code:35739-7450
Practice Address - Country:US
Practice Address - Phone:256-423-8989
Practice Address - Fax:256-423-8990
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-26
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL110617183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes183500000XPharmacy Service ProvidersPharmacistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
ALNCPDPOther0126412