The Drug Store Co Inc

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

110332 Issued in AL

Legal business name

THE DRUG STORE CO INC

Practice address

583 4TH Ave
York, AL 36925-2008

Phone

(205) 392-5201

Fax

(205) 392-7006

NPI assigned

Jun 11, 2006

Organization subpart

No

Name

Lee Davis

Title

Pic Owner

Phone

(205) 392-5201

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

• York Drug, Inc.

  • Durable Medical Equipment & Medical Supplies
  • Livingston, AL
  • NPI 1962410449

  O20100930063759

  Same enrollment

Medicare fee-for-service enrollment

Enrolled in AL

Enrollment records 1

• YORK DRUG STORE Doing business as

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Apr 15, 2020.

{
    "created_epoch": "1149984000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1586908800000",
    "number": "1497797062",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1246",
            "city": "LIVINGSTON",
            "state": "AL",
            "postal_code": "354701246"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "583 4TH AVE",
            "city": "YORK",
            "state": "AL",
            "postal_code": "369252008",
            "telephone_number": "205-392-5201",
            "fax_number": "205-392-7006"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THE DRUG STORE CO INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-11",
        "last_updated": "2020-04-15",
        "certification_date": "2020-04-15",
        "status": "A",
        "authorized_official_last_name": "DAVIS",
        "authorized_official_first_name": "LEE",
        "authorized_official_title_or_position": "PIC OWNER",
        "authorized_official_telephone_number": "205-392-5201"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "AL",
            "license": "110332",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100000701",
            "state": "AL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0037389",
            "state": "MS"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "1989272",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "YORK DRUG STORE",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "YORK DRUG STORE",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• All providers in York, AL
• Community/Retail Pharmacy in Alabama

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 15, 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.