NPIMap

Organization Active NPI

Parks Pharmacy Inc

  • Community/Retail Pharmacy
  • Hayneville, AL
National Provider Identifier
1215058797
Registry record updated Feb 29, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
License
112816 Issued in AL
Legal business name
PARKS PHARMACY INC
Practice address
225 Hayneville PLZ
Hayneville, AL 36040-2669
Phone
(334) 548-6240
Fax
(334) 323-5663
NPI assigned
Apr 3, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 29, 2012

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

Authorized official

Name
Demetrius Parks
Title
President
Phone
(334) 799-1489

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacy 333600000X
Community/Retail Pharmacy 3336C0003X 112816 AL Primary

Addresses

Primary practice location

225 Hayneville PLZ
Hayneville, AL 36040-2669

Mailing address

PO Box 250310
Montgomery, AL 36125-0310
Phone (334) 548-6240

Other identifiers 3

IdentifierTypeStateIssuer
0132364OtherNCPDP PROVIDER IDENTIFICATION NUMBER
100003543MedicaidAL
100003578MedicaidAL

Other names 1

  • PARKS PHARMACY #1 Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Parks Pharmacy4 organizations share this tax ID, including this one

Other organizations with this tax ID 3

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": "1175558400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1330473600000",
    "number": "1215058797",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 250310",
            "city": "MONTGOMERY",
            "state": "AL",
            "postal_code": "361250310",
            "telephone_number": "334-548-6240",
            "fax_number": "334-548-6246"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "225 HAYNEVILLE PLZ",
            "city": "HAYNEVILLE",
            "state": "AL",
            "postal_code": "360402669",
            "telephone_number": "334-548-6240",
            "fax_number": "334-323-5663"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PARKS PHARMACY INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-03",
        "last_updated": "2012-02-29",
        "status": "A",
        "authorized_official_last_name": "PARKS",
        "authorized_official_first_name": "DEMETRIUS",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "334-799-1489"
    },
    "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": "112816",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NCPDP PROVIDER IDENTIFICATION NUMBER",
            "identifier": "0132364",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100003543",
            "state": "AL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100003578",
            "state": "AL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "PARKS PHARMACY #1",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Hayneville, AL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 29, 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.