Organization Active NPI

Valley Pharmacy & DME of East Alabama Inc

  • Long Term Care Pharmacy
  • Valley, AL
National Provider Identifier
1265085252
Registry record updated Jul 19, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Long Term Care PharmacyTaxonomy code 3336L0003X
Legal business name
VALLEY PHARMACY & DME OF EAST ALABAMA INC
Practice address
4103 20TH Ave
Valley, AL 36854-3448
Phone
(334) 756-2037
Fax
(334) 756-9024
NPI assigned
Jul 19, 2019
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 19, 2019

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

Authorized official

Name
Craig Lane Moore
Title
Owner
Phone
(334) 756-2037

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Long Term Care Pharmacy 3336L0003X Primary

Addresses

Primary practice location

4103 20TH Ave
Valley, AL 36854-3448

Mailing address

4103 20TH Ave
Valley, AL 36854-3448
Phone (334) 756-2037

Other identifiers 1

IdentifierTypeStateIssuer
1388888MedicaidAL

National Provider Directory

National Provider Directory

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": "1563494400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1563494400000",
    "number": "1265085252",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4103 20TH AVE",
            "city": "VALLEY",
            "state": "AL",
            "postal_code": "368543448",
            "telephone_number": "334-756-2037",
            "fax_number": "334-756-9024"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4103 20TH AVE",
            "city": "VALLEY",
            "state": "AL",
            "postal_code": "368543448",
            "telephone_number": "334-756-2037",
            "fax_number": "334-756-9024"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VALLEY PHARMACY & DME OF EAST ALABAMA INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-07-19",
        "last_updated": "2019-07-19",
        "status": "A",
        "authorized_official_last_name": "MOORE",
        "authorized_official_first_name": "CRAIG",
        "authorized_official_middle_name": "LANE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "334-756-2037"
    },
    "taxonomies": [
        {
            "code": "3336L0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Long Term Care Pharmacy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1388888",
            "state": "AL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Valley, AL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 19, 2019; 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.