Organization Active NPI

Foodland Pharmacy SB LLC

  • Community/Retail Pharmacy
  • Scottsboro, AL
National Provider Identifier
1235567355
Registry record updated Jul 8, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
License
114233 Issued in AL
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

Updated by the provider on Jul 8, 2024

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.NPI 1740496256
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)CodeLicenseStatePrimary
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

IdentifierTypeStateIssuer
2142791OtherPK
154030MedicaidAL

Other names 2

  • Foodland Pharmacy SB Doing business as
  • Foodland Pharmacy SB, LLC Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20150827002931 AL Part B Supplier - Mass Immunization (Roster Biller Only) 5294041844 Practice locations: Scottsboro, AL

National Provider Directory

National Provider Directory

Locations

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.

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.

Verify at the official NPI Registry.