Fayette Pharmacy Inc

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

105645 Issued in AL

Legal business name

FAYETTE PHARMACY INC

Practice address

13532 Highway 96
Millport, AL 35576-2522

Phone

(205) 662-3817

Fax

(205) 662-4757

NPI assigned

Aug 28, 2007

Organization subpart

No

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

Authorized official

Name

Summer Wilson

Title

Owner/Pharmacist

Phone

(205) 712-1685

Specialties & licenses 2

Addresses

Other identifiers 1

Other names 1

• Joe Golden Drug Doing business as

Locations

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

{
    "created_epoch": "1188259200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1487548800000",
    "number": "1740474204",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 408",
            "city": "MILLPORT",
            "state": "AL",
            "postal_code": "355760408",
            "telephone_number": "205-662-3817",
            "fax_number": "205-662-4757"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13532 HIGHWAY 96",
            "city": "MILLPORT",
            "state": "AL",
            "postal_code": "355762522",
            "telephone_number": "205-662-3817",
            "fax_number": "205-662-4757"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FAYETTE PHARMACY INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-08-28",
        "last_updated": "2017-02-20",
        "status": "A",
        "authorized_official_last_name": "WILSON",
        "authorized_official_first_name": "SUMMER",
        "authorized_official_title_or_position": "OWNER/PHARMACIST",
        "authorized_official_telephone_number": "205-712-1685"
    },
    "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": "105645",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2138253",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Joe Golden Drug",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• FMC Medical Clinic Millport
• Lamar Primary Care LLC
• Hannah L Livingston, CRNP
• Lulu and Laura Foundation
• Millport Fam Practice Clinic, LLC

• Community/Retail Pharmacy in Millport, AL
• Providers in Millport, AL by specialty
• Community/Retail Pharmacy in Alabama

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 20, 2017; 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.