Provider Demographics
NPI:1518282748
Name:MAYS, JAMEY A III (RPH)
Entity Type:Individual
Prefix:
First Name:JAMEY
Middle Name:A
Last Name:MAYS
Suffix:III
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:922 20TH ST
Mailing Address - Street 2:
Mailing Address - City:HALEYVILLE
Mailing Address - State:AL
Mailing Address - Zip Code:35565-1324
Mailing Address - Country:US
Mailing Address - Phone:205-486-3197
Mailing Address - Fax:
Practice Address - Street 1:922 20TH ST
Practice Address - Street 2:
Practice Address - City:HALEYVILLE
Practice Address - State:AL
Practice Address - Zip Code:35565-1324
Practice Address - Country:US
Practice Address - Phone:205-486-3197
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-03-31
Last Update Date:2010-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL13759183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL100003471Medicaid
510G730016OtherMEDICARE PTAN NUMBER ISSUED BY CAHABA
4005810003Medicare NSC