Provider Demographics
NPI:1225130628
Name:ECONOMY DRUGS OF HUNTSVILLE INC
Entity Type:Organization
Organization Name:ECONOMY DRUGS OF HUNTSVILLE INC
Other - Org Name:ECONOMY DRUG
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:HALEY
Authorized Official - Middle Name:RAY
Authorized Official - Last Name:GILLHAM
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:479-738-2620
Mailing Address - Street 1:PO BOX 157
Mailing Address - Street 2:
Mailing Address - City:HUNTSVILLE
Mailing Address - State:AR
Mailing Address - Zip Code:72740-0157
Mailing Address - Country:US
Mailing Address - Phone:479-738-2620
Mailing Address - Fax:479-738-6973
Practice Address - Street 1:601 N GASKILL ST
Practice Address - Street 2:
Practice Address - City:HUNTSVILLE
Practice Address - State:AR
Practice Address - Zip Code:72740-6001
Practice Address - Country:US
Practice Address - Phone:479-738-2620
Practice Address - Fax:479-738-6973
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-05
Last Update Date:2022-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
332B00000X, 333600000X, 3336L0003X
ARAR036863336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No332B00000XSuppliersDurable Medical Equipment & Medical Supplies
No333600000XSuppliersPharmacy
No3336L0003XSuppliersPharmacyLong Term Care Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR100553407Medicaid
0403686OtherNCPDP PROVIDER IDENTIFICATION NUMBER
0403686OtherNCPDP PROVIDER IDENTIFICATION NUMBER