Fort Deposit Drug Pharmacy LLC

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

113013 Issued in AL

Legal business name

FORT DEPOSIT DRUG PHARMACY LLC

Doing business as

Fort Deposit Drug Pharmacy LLC

Practice address

120 S Pollard St
Fort Deposit, AL 36032-3825

Phone

(334) 227-7777

Fax

(334) 227-4466

NPI assigned

Jan 8, 2008

Last updated

May 25, 2011By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Kenneth Hayes

Title

President

Phone

(205) 401-7911

Specialties & licenses 1

Addresses

Other identifiers 2

Other names 1

• FORT DEPOSIT DRUG PHARMACY LLC Doing business as

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

{
    "created_epoch": "1199750400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1306281600000",
    "number": "1124203211",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 280",
            "city": "FORT DEPOSIT",
            "state": "AL",
            "postal_code": "360320280",
            "telephone_number": "334-227-7777",
            "fax_number": "334-227-4466"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "120 S POLLARD ST",
            "city": "FORT DEPOSIT",
            "state": "AL",
            "postal_code": "360323825",
            "telephone_number": "334-227-7777",
            "fax_number": "334-227-4466"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FORT DEPOSIT DRUG PHARMACY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-01-08",
        "last_updated": "2011-05-25",
        "status": "A",
        "authorized_official_last_name": "HAYES",
        "authorized_official_first_name": "KENNETH",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "205-401-7911"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "AL",
            "license": "113013",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NCPDP PROVIDER IDENTIFICATION NUMBER",
            "identifier": "0135029",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "113013",
            "state": "AL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "FORT DEPOSIT DRUG PHARMACY LLC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Community/Retail Pharmacy in Fort Deposit, AL
• Providers in Fort Deposit, AL by specialty
• Community/Retail Pharmacy in Alabama

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 25, 2011; 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.