Provider Demographics
NPI:1235202565
Name:PAYLESS DRUGS, INC.
Entity Type:Organization
Organization Name:PAYLESS DRUGS, INC.
Other - Org Name:PAYLESS DRUGS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ARTHUR
Authorized Official - Middle Name:B
Authorized Official - Last Name:ENNIS
Authorized Official - Suffix:JR
Authorized Official - Credentials:PHARMD
Authorized Official - Phone:205-647-0515
Mailing Address - Street 1:585 MORRIS MAJESTIC RD
Mailing Address - Street 2:
Mailing Address - City:MORRIS
Mailing Address - State:AL
Mailing Address - Zip Code:35116
Mailing Address - Country:US
Mailing Address - Phone:205-647-0515
Mailing Address - Fax:205-647-5666
Practice Address - Street 1:585 MORRIS MAJESTIC RD
Practice Address - Street 2:
Practice Address - City:MORRIS
Practice Address - State:AL
Practice Address - Zip Code:35116-1246
Practice Address - Country:US
Practice Address - Phone:205-647-0515
Practice Address - Fax:205-647-5666
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:PAYLESS DRUGS, INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-11-16
Last Update Date:2020-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL100003108Medicaid
AL1309810003Medicare NSC