NPIMap

Organization Active NPI

Sand Drug Inc

  • Community/Retail Pharmacy
  • Decatur, AL
National Provider Identifier
1154461200
Registry record updated Mar 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
License
107541 Issued in AL
Legal business name
SAND DRUG INC
Practice address
1206 7TH St SE
Decatur, AL 35601-3338
Phone
(256) 353-5011
Fax
(256) 355-5152
NPI assigned
Feb 7, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 7, 2023

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

Authorized official

Name
Blake Lee GowenNPI 1982741401
Title
Owner/RPH in Charge
Phone
(256) 353-5011

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 2

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Retail Pharmacy 3336C0003X 107541 AL Primary
Compounding Pharmacy 3336C0004X 107541 AL

Addresses

Primary practice location

1206 7TH St SE
Decatur, AL 35601-3338

Mailing address

1206 7TH St SE
Decatur, AL 35601-3338
Phone (256) 353-5011

Other practice location 1

1207 Medical Dr SE
Decatur, AL 35601-4330
Phone (256) 353-5011

Other identifiers 3

IdentifierTypeStateIssuer
0111790OtherALNCPDP NUMBER
100003745MedicaidAL
107541OtherALALABAMA PHARMACY LICENSE

Other names 1

  • PAY-LESS DRIVE-IN PHARMACY Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Sand Drugs Inc3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

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

Locations

1207 Medical Dr SE
Decatur, AL 35601
Phone (256) 353-5011

Practitioners & affiliated clinicians

Practitioners 3

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": "1170806400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1678147200000",
    "number": "1154461200",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1206 7TH ST SE",
            "city": "DECATUR",
            "state": "AL",
            "postal_code": "356013338",
            "telephone_number": "256-353-5011",
            "fax_number": "256-355-5152"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1206 7TH ST SE",
            "city": "DECATUR",
            "state": "AL",
            "postal_code": "356013338",
            "telephone_number": "256-353-5011",
            "fax_number": "256-355-5152"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1207 Medical Dr SE",
            "address_purpose": "LOCATION",
            "city": "Decatur",
            "state": "AL",
            "postal_code": "356014330",
            "country_code": "US",
            "telephone_number": "256-353-5011",
            "fax_number": "256-355-5152",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "SAND DRUG INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-07",
        "last_updated": "2023-03-07",
        "status": "A",
        "authorized_official_last_name": "GOWEN",
        "authorized_official_first_name": "BLAKE",
        "authorized_official_middle_name": "LEE",
        "authorized_official_title_or_position": "OWNER/RPH IN CHARGE",
        "authorized_official_telephone_number": "256-353-5011"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "AL",
            "license": "107541",
            "primary": true
        },
        {
            "code": "3336C0004X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Compounding Pharmacy",
            "state": "AL",
            "license": "107541",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NCPDP NUMBER",
            "identifier": "0111790",
            "state": "AL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100003745",
            "state": "AL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ALABAMA PHARMACY LICENSE",
            "identifier": "107541",
            "state": "AL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "PAY-LESS DRIVE-IN PHARMACY",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "PAY-LESS DRIVE-IN PHARMACY",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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 Mar 7, 2023; 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.