Hayden Family Pharmacy P C

Key facts

NPI: 1063792018
Entity type: Organization (NPI type 2)
Primary specialty: Community/Retail Pharmacy 3336C0003X
License: 113797 (AL)
Legal business name: HAYDEN FAMILY PHARMACY P C
Practice address: 88 White Oak TRL
Warrior, AL 35180-4214
Phone: (205) 590-1100
Fax: (205) 590-1120
NPI assigned: Aug 23, 2011
Organization subpart: No

Authorized official

Name: Jennifer Metcalf NPI 1598355075
Title: President
Phone: (205) 590-1100

Authorized official NPPES reports the authorized official by name only; the link goes to the one practitioner connected to this organization with that name.

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

Hayden Family Pharmacy PC Durable Medical Equipment & Medical Supplies · Hayden, AL · NPI 1619155744

Same enrollment O20120629000182

Corporate family (same tax ID) 1

Organizations that report the same tax identification number in the National Provider Directory.

Hayden Family Pharmacy PC Durable Medical Equipment & Medical Supplies · Hayden, AL · NPI 1619155744

NPD tax ID

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

Jennifer Metcalf, RPH Pharmacist · Hayden, AL · NPI 1598355075

NPD (past) Authorized official
Michael Andrew Allison Pharmacist · Warrior, AL · NPI 1356931828

NPD (past)

Laboratory certificates & supplier records

Name & address match These CMS records do not include an NPI. They are shown here because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA number	Laboratory	Certificate	Expires
01D2107084	Shipp'S Discount Pharmacy 88 White Oak Trail, Warrior, AL 35180	Certificate of waiver	Jan 5, 2028

Medicare participation

Medicare fee-for-service enrollment: Enrolled in AL

Medicare enrollment records

Enrollment ID	State	Provider type	PAC ID	Details
O20120629000182	AL	Part B Supplier - Mass Immunization (Roster Biller Only)	1355546664	1 other NPI on this enrollment This NPI is an additional NPI on the enrollment Practice locations: Hayden, AL; Warrior, AL

National Provider Directory

Tax ID family: Hayden Family Pharmacy PC (2 organizations share this tax ID)

Locations

310 3rd St
Hayden, AL 35079
Phone (205) 590-1515

4086 State Highway 160
Hayden, AL 35079
Phone (205) 590-1515

88 White Oak Trl
Warrior, AL 35180
Phone (205) 590-1100

Specialties & licenses

Specialty (taxonomy)	Code	License	State	Primary
Pharmacy	333600000X
Community/Retail Pharmacy	3336C0003X	113797	AL	Yes

Addresses

Primary practice location

88 White Oak TRL
Warrior, AL 35180-4214

Mailing address

PO Box 665
Hayden, AL 35079-0665
Phone (205) 590-1100

Other identifiers

Identifier	Type	State	Issuer
01D2107084	Other	AL	CLIA
2131605	Other		PK
1063792018	Medicaid	AL

Other names

SHIPP'S DISCOUNT PHARMACY Doing business as

Other providers in Warrior, AL

All providers in Warrior, 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 Sep 13, 2020. 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.

Verify at the official NPI Registry.