Organization Active NPI

Payless Pharmacy Express #2, Inc

  • Community/Retail Pharmacy
  • Decatur, AL
National Provider Identifier
1114950235
Registry record updated Jan 11, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
License
110475 Issued in AL
Legal business name
PAYLESS PHARMACY EXPRESS #2, INC
Practice address
1517 Moulton St W
Decatur, AL 35601-2149
Phone
(256) 355-1815
Fax
(256) 350-5300
NPI assigned
Jul 9, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 11, 2012

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

Authorized official

Name
Mr. Jeff D Camp
Title
Owner
Phone
(256) 355-1815

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Retail Pharmacy 3336C0003X 110475 AL Primary

Addresses

Primary practice location

1517 Moulton St W
Decatur, AL 35601-2149

Mailing address

1517 Moulton St W
Decatur, AL 35601-2149
Phone (256) 355-1815

Other identifiers 1

IdentifierTypeStateIssuer
000050305MedicaidAL

National Provider Directory

National Provider Directory

Locations

1517 Moulton St W
Decatur, AL 35601
Phone (256) 355-1815

Practitioners & affiliated clinicians

Practitioners 1

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

NPI Registry JSON

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

{
    "created_epoch": "1152403200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1326240000000",
    "number": "1114950235",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1517 MOULTON ST W",
            "city": "DECATUR",
            "state": "AL",
            "postal_code": "356012149",
            "telephone_number": "256-355-1815",
            "fax_number": "256-350-5300"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1517 MOULTON ST W",
            "city": "DECATUR",
            "state": "AL",
            "postal_code": "356012149",
            "telephone_number": "256-355-1815",
            "fax_number": "256-350-5300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PAYLESS PHARMACY EXPRESS #2, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-09",
        "last_updated": "2012-01-11",
        "status": "A",
        "authorized_official_last_name": "CAMP",
        "authorized_official_first_name": "JEFF",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "256-355-1815",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "AL",
            "license": "110475",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000050305",
            "state": "AL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Decatur, AL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 11, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.