Active NPI
Foodland Pharmacy SB LLC
- Community/Retail Pharmacy
- Scottsboro, AL
National Provider Identifier
1235567355
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Community/Retail Pharmacy
- License
- 114233
- Legal business name
- FOODLAND PHARMACY SB LLC
- Practice address
- 1402 County Park Rd Ste 1
Scottsboro, AL 35769-3968 - Phone
- (256) 259-1011
- Fax
- (256) 259-1138
- NPI assigned
- Oct 29, 2013
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Dr. David John Kinsley, PHARM.D.
- Title
- Pharmacy Manager/Owner
- Phone
- (256) 259-1011
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) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacy | 333600000X | |||
| Community/Retail Pharmacy | 3336C0003X | 114233 | AL | Primary |
Addresses
Primary practice location
1402 County Park Rd Ste 1
Scottsboro, AL 35769-3968
Mailing address
1402 County Park Rd Ste 1
Scottsboro, AL 35769-3968
Phone (256) 259-1011
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 2142791 | Other | PK | |
| 154030 | Medicaid | AL |
Other names 2
- Foodland Pharmacy SB
- Foodland Pharmacy SB, LLC
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in AL
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20150827002931 | AL | Part B Supplier - Mass Immunization (Roster Biller Only) | 5294041844 | Practice locations: Scottsboro, AL |
National Provider Directory
National Provider DirectoryLocations
1402 County Park Rd
Ste 1
Scottsboro, AL 35769
Phone (256) 259-1011
Practitioners & affiliated clinicians
Practitioners 1
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Pharmacist
- Scottsboro, AL
- NPI 1740496256
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1383004800000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1720396800000",
"number": "1235567355",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1402 COUNTY PARK RD STE 1",
"city": "SCOTTSBORO",
"state": "AL",
"postal_code": "357693968",
"telephone_number": "256-259-1011",
"fax_number": "256-259-1138"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1402 COUNTY PARK RD STE 1",
"city": "SCOTTSBORO",
"state": "AL",
"postal_code": "357693968",
"telephone_number": "256-259-1011",
"fax_number": "256-259-1138"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "FOODLAND PHARMACY SB LLC",
"organizational_subpart": "NO",
"enumeration_date": "2013-10-29",
"last_updated": "2024-07-08",
"certification_date": "2024-07-08",
"status": "A",
"authorized_official_last_name": "KINSLEY",
"authorized_official_first_name": "DAVID",
"authorized_official_middle_name": "JOHN",
"authorized_official_title_or_position": "PHARMACY MANAGER/OWNER",
"authorized_official_telephone_number": "256-259-1011",
"authorized_official_name_prefix": "Dr.",
"authorized_official_credential": "PHARM.D."
},
"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": "114233",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PK",
"identifier": "2142791",
"state": null
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "154030",
"state": "AL"
}
],
"endpoints": [],
"other_names": [
{
"organization_name": "Foodland Pharmacy SB",
"code": "3",
"type": "Doing Business As"
},
{
"organization_name": "Foodland Pharmacy SB, LLC",
"code": "3",
"type": "Doing Business As"
}
]
}
Other providers in Scottsboro, AL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2024; 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.