Provider Demographics
NPI:1689721946
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:BOYD
Authorized Official - Last Name:ENNIS
Authorized Official - Suffix:JR
Authorized Official - Credentials:PHARMD
Authorized Official - Phone:205-252-4179
Mailing Address - Street 1:2512 31ST AVE N
Mailing Address - Street 2:
Mailing Address - City:BIRMINGHAM
Mailing Address - State:AL
Mailing Address - Zip Code:35207-4424
Mailing Address - Country:US
Mailing Address - Phone:205-252-4179
Mailing Address - Fax:205-252-4170
Practice Address - Street 1:2512 31ST AVE N
Practice Address - Street 2:
Practice Address - City:BIRMINGHAM
Practice Address - State:AL
Practice Address - Zip Code:35207-4424
Practice Address - Country:US
Practice Address - Phone:205-252-4179
Practice Address - Fax:205-252-4170
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:PAYLESS DRUGS, INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2007-01-05
Last Update Date:2020-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL1076783336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL100002535Medicaid