Provider Demographics
NPI:1366509051
Name:BYNUM DRUG INC
Entity Type:Organization
Organization Name:BYNUM DRUG INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHARMACIST
Authorized Official - Prefix:MS
Authorized Official - First Name:AMANDA
Authorized Official - Middle Name:K
Authorized Official - Last Name:GUINN
Authorized Official - Suffix:
Authorized Official - Credentials:PHARMACIST
Authorized Official - Phone:256-237-7533
Mailing Address - Street 1:PO BOX 368
Mailing Address - Street 2:
Mailing Address - City:BYNUM
Mailing Address - State:AL
Mailing Address - Zip Code:36253
Mailing Address - Country:US
Mailing Address - Phone:256-237-7533
Mailing Address - Fax:256-237-7537
Practice Address - Street 1:8749 AL HIGHWAY 202
Practice Address - Street 2:
Practice Address - City:EASTABOGA
Practice Address - State:AL
Practice Address - Zip Code:36260
Practice Address - Country:US
Practice Address - Phone:256-237-7533
Practice Address - Fax:256-237-7537
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-02
Last Update Date:2022-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL102005333600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes333600000XSuppliersPharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL100001234Medicaid