Organization Active NPI

Pill Box Pharmacy Inc

  • Pharmacy
  • Decatur, AL
National Provider Identifier
1558459966
Registry record updated Dec 17, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacyTaxonomy code 333600000X
License
110436 Issued in AL
Legal business name
PILL BOX PHARMACY INC
Practice address
474 Hwy 67 South
Decatur, AL 35603
Phone
(256) 353-0100
Fax
(256) 353-0299
NPI assigned
Oct 11, 2006
Last updated
Dec 17, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 17, 2020

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

Authorized official

Name
Mr. Rickey Edwin Clay, RPHNPI 1770754533
Title
Owner Pharmacist
Phone
(256) 353-0100

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
Pharmacy 333600000X 110436 AL Primary

Addresses

Primary practice location

474 Hwy 67 South
Decatur, AL 35603

Mailing address

474 Hwy 67 South
Decatur, AL 35603
Phone (256) 353-0100

Other identifiers 1

IdentifierTypeStateIssuer
100002689MedicaidAL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AL2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20100930035760 AL DME Supplier - Pharmacy 7113048752 Practice locations: Decatur, AL
O20190517000177 AL Part B Supplier - Mass Immunization (Roster Biller Only) 7113048752 Practice locations: Decatur, AL

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
01D2291581The Pill Box Pharmacy474 Hwy 675, Decatur, AL 35603Certificate of waiverOct 11, 2027

National Provider Directory

National Provider Directory

Locations

474 Highway 67 S
Decatur, AL 35603
Phone (256) 353-0100

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1160524800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1608163200000",
    "number": "1558459966",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "474 HWY 67 SOUTH",
            "city": "DECATUR",
            "state": "AL",
            "postal_code": "35603",
            "telephone_number": "256-353-0100",
            "fax_number": "256-353-0299"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "474 HWY 67 SOUTH",
            "city": "DECATUR",
            "state": "AL",
            "postal_code": "35603",
            "telephone_number": "256-353-0100",
            "fax_number": "256-353-0299"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PILL BOX PHARMACY INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-11",
        "last_updated": "2020-12-17",
        "certification_date": "2020-12-17",
        "status": "A",
        "authorized_official_last_name": "CLAY",
        "authorized_official_first_name": "RICKEY",
        "authorized_official_middle_name": "EDWIN",
        "authorized_official_title_or_position": "OWNER  PHARMACIST",
        "authorized_official_telephone_number": "256-353-0100",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "RPH"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": "AL",
            "license": "110436",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100002689",
            "state": "AL"
        }
    ],
    "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 Dec 17, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.