Fyffe Pharmacy, LLC
Organization Active NPI Community/Retail Pharmacy · Fyffe, AL
NPI 1043366800 · NPPES record last updated Apr 28, 2008
Key facts
- NPI
- 1043366800
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Community/Retail Pharmacy 3336C0003X
- License
- 104223 (AL)
- Legal business name
- FYFFE PHARMACY, LLC
- Practice address
- 44 Blackwell St.
Fyffe, AL 35971-0067 - Phone
- (256) 623-2944
- Fax
- (256) 623-3938
- NPI assigned
- Jan 26, 2007
- Organization subpart
- No
Authorized official
- Name
- Mr. Brandon L. Rains
- Title
- Owner
- Phone
- (256) 623-2944
Practitioners 2
-
Brandon Lee Rains, RPH
-
Cheree Reed Rains, RPH
Laboratory certificates & supplier records
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 01D2195886 | Fyffe Pharmacy, LLC | Certificate of waiver | Oct 12, 2026 |
Medicare medical equipment & supply locations
| Supplier | Supplies | Medicare assignment |
|---|---|---|
| Fyffe Pharmacy LLC |
Immunosuppressive Drugs|Nebulizer Drugs|Oral Anticancer Drugs|Oral Antiemetic Drugs|Commodes, Urinals, Bedpans|Blood Glucose Monitors/Supplies (Non-Mail Order)|Canes and/or Crutches|Walkers|Orthoses: Off-The-Shelf|Ostomy Supplies|Urological Supplies|Surgical Dressings | Does not accept assignment |
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled (2 enrollments) in AL
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20071128000709 | AL | Part B Supplier - Mass Immunization (Roster Biller Only) | 0547359564 | Practice locations: Fyffe, AL |
| O20100930085034 | AL | DME Supplier - Pharmacy | 0547359564 | Practice locations: Fyffe, AL |
National Provider Directory
Locations
44 Blackwell St
Fyffe, AL 35971
Phone (256) 623-2944
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Community/Retail Pharmacy | 3336C0003X | 104223 | AL | Yes |
Addresses
Primary practice location
44 Blackwell St.
Fyffe, AL 35971-0067
Mailing address
PO Box 67
Fyffe, AL 35971-0067
Phone (256) 623-2944
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0106852 | Other | AL | NCPDP |
| 009911130 | Other | AL | MEDICAID DME |
| 510G730002 | Other | AL | MEDICARE PART B IMMUNIZATION PROVIDER NUMBER |
| 100003781 | Medicaid | AL |
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- Dental Associates of Fyffe, LLC
- Dr. Austin S Wright LLC
- Ashley Bryant Holcomb
- Jackson County Community Services, Inc.
- Reginald R Jones
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- Georgina Kay Knopps
All providers in Fyffe, AL · Community/Retail Pharmacy in Alabama
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 28, 2008. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.