Organization Active NPI

Cottonwood Drugs LLC

  • Community/Retail Pharmacy
  • Cottonwood, AL
National Provider Identifier
1124467402
Registry record updated Mar 31, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
License
114137 Issued in AL
Legal business name
COTTONWOOD DRUGS LLC
Practice address
12890 Cottonwood Rd
Cottonwood, AL 36320-4293
Phone
(334) 691-3784
NPI assigned
Jun 19, 2013
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 31, 2022

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

Authorized official

Name
James Ryan FolsomNPI 1780916957
Title
Owner/Pharmacist
Phone
(334) 691-3784

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Retail Pharmacy 3336C0003X 114137 AL Primary

Addresses

Primary practice location

12890 Cottonwood Rd
Cottonwood, AL 36320-4293

Mailing address

PO Box 130
Cottonwood, AL 36320-0130
Phone (334) 691-3784

Other identifiers 1

IdentifierTypeStateIssuer
150123MedicaidAL

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20220401000580 AL Part B Supplier - Pharmacy 7315333226 Practice locations: Cottonwood, AL

National Provider Directory

National Provider Directory

Locations

12890 Cottonwood Rd
Cottonwood, AL 36320
Phone (334) 691-3784

13182 Cottonwood Rd
Cottonwood, AL 36320

Practitioners & affiliated clinicians

Practitioners 2

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": "1371600000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1648684800000",
    "number": "1124467402",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 130",
            "city": "COTTONWOOD",
            "state": "AL",
            "postal_code": "363200130",
            "telephone_number": "334-691-3784"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12890 COTTONWOOD RD",
            "city": "COTTONWOOD",
            "state": "AL",
            "postal_code": "363204293",
            "telephone_number": "334-691-3784"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COTTONWOOD DRUGS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-06-19",
        "last_updated": "2022-03-31",
        "certification_date": "2022-03-31",
        "status": "A",
        "authorized_official_last_name": "FOLSOM",
        "authorized_official_first_name": "JAMES",
        "authorized_official_middle_name": "RYAN",
        "authorized_official_title_or_position": "OWNER/PHARMACIST",
        "authorized_official_telephone_number": "334-691-3784"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "AL",
            "license": "114137",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "150123",
            "state": "AL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Cottonwood, AL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 31, 2022; 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.