NPIMap

Organization Active NPI

Valley Drug Company #2

  • Pharmacist
  • Decatur, AL
National Provider Identifier
1487763447
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
109885 Issued in AL
Legal business name
VALLEY DRUG COMPANY #2
Practice address
1101 16TH Ave. SE
Decatur, AL 35601-3594
Phone
(256) 355-6225
NPI assigned
Aug 30, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Mustafa Issa ElayanNPI 1962519850
Title
President
Phone
(256) 355-6225

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 1

Specialty (taxonomy)CodeLicenseStatePrimary
PharmacistGroup: 193200000X MULTI-SPECIALTY GROUP 183500000X 109885 AL Primary

Addresses

Primary practice location

1101 16TH Ave. SE
Decatur, AL 35601-3594

Mailing address

1101 16TH Ave SE
Decatur, AL 35601-3594
Phone (256) 355-6225

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20210203000989 AL Part B Supplier - Mass Immunization (Roster Biller Only) 9335268143 Practice locations: Decatur, AL

National Provider Directory

National Provider Directory
Tax ID family
Valley Drug Co Inc4 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.

Locations

1302 Somerville Rd SE
Decatur, AL 35601
Phone (256) 355-8015

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": "1156896000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1487763447",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1101 16TH AVE SE",
            "city": "DECATUR",
            "state": "AL",
            "postal_code": "356013594",
            "telephone_number": "256-355-6225"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1101 16TH AVE. SE",
            "city": "DECATUR",
            "state": "AL",
            "postal_code": "356013594",
            "telephone_number": "256-355-6225"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VALLEY DRUG COMPANY #2",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-30",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "ELAYAN",
        "authorized_official_first_name": "MUSTAFA",
        "authorized_official_middle_name": "ISSA",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "256-355-6225"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Pharmacist",
            "state": "AL",
            "license": "109885",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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 Aug 22, 2020; 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.