NPIMap

Organization Active NPI

Montgomery Drug Company Inc

  • Community/Retail Pharmacy
  • Montgomery, AL
National Provider Identifier
1104923945
Registry record updated Nov 22, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
License
101016 Issued in AL
Legal business name
MONTGOMERY DRUG COMPANY INC
Practice address
35 Mitchell Dr
Montgomery, AL 36109-2923
Phone
(334) 272-0802
Fax
(334) 272-0882
NPI assigned
Sep 20, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 22, 2016

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Chris Phung, RPH
Title
Pharmacist in Charge
Phone
(334) 272-0802

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacy 333600000X
Community/Retail Pharmacy 3336C0003X 101016 AL Primary

Addresses

Primary practice location

35 Mitchell Dr
Montgomery, AL 36109-2923

Mailing address

35 Mitchell Dr
Montgomery, AL 36109-2923
Phone (334) 272-0802

Other identifiers 2

IdentifierTypeStateIssuer
100002564MedicaidAL
1991395OtherPK

Other names 1

  • ADAMS DRUGS-EAST Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20160913001314 AL Part B Supplier - Pharmacy 2860648284 9 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Montgomery, AL; Wetumpka, AL; Prattville, AL; Millbrook, AL; Deatsville, AL

Other NPIs on the same Medicare enrollment 9

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

National Provider Directory

National Provider Directory
Tax ID family
Montgomery Drug Company Inc12 organizations share this tax ID, including this one

Other organizations with this tax ID 11

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

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1158710400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1479772800000",
    "number": "1104923945",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "35 MITCHELL DR",
            "city": "MONTGOMERY",
            "state": "AL",
            "postal_code": "361092923",
            "telephone_number": "334-272-0802",
            "fax_number": "334-272-0882"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "35 MITCHELL DR",
            "city": "MONTGOMERY",
            "state": "AL",
            "postal_code": "361092923",
            "telephone_number": "334-272-0802",
            "fax_number": "334-272-0882"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MONTGOMERY DRUG COMPANY INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-20",
        "last_updated": "2016-11-22",
        "status": "A",
        "authorized_official_last_name": "PHUNG",
        "authorized_official_first_name": "CHRIS",
        "authorized_official_title_or_position": "PHARMACIST IN CHARGE",
        "authorized_official_telephone_number": "334-272-0802",
        "authorized_official_credential": "RPH"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "AL",
            "license": "101016",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100002564",
            "state": "AL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "1991395",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "ADAMS DRUGS-EAST",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Montgomery, AL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 22, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.