Organization Active NPI

Dixie Independent Enterprises, LLC

Doing business as Anderson Pharmacy

  • Pharmacy
  • Altoona, AL
National Provider Identifier
1780024679
Registry record updated Dec 4, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacyTaxonomy code 333600000X
License
101165 Issued in AL
Legal business name
DIXIE INDEPENDENT ENTERPRISES, LLC
Doing business as
Anderson Pharmacy
Practice address
7101 Etowah St
Altoona, AL 35952
Phone
(205) 589-6557
Fax
(205) 589-6553
NPI assigned
Jun 25, 2013
Last updated
Dec 4, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 4, 2020

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

Authorized official

Name
Dr. Gabriel Argo, PHARMDNPI 1639655590
Title
Ower
Phone
(205) 589-6557

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 3

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X
Pharmacy 333600000X 101165 AL Primary
Pharmacy 333600000X

Addresses

Primary practice location

7101 Etowah St
Altoona, AL 35952

Mailing address

PO Box 7
Altoona, AL 35952
Phone (205) 589-6557

Other identifiers 1

IdentifierTypeStateIssuer
100001368MedicaidAL

Other names 1

  • Anderson Pharmacy Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20210310002974 AL Part B Supplier - Pharmacy 8820404189 Practice locations: Altoona, 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
01D2195311Anderson Pharmacy7101 Etowah Street, Altoona, AL 35952Certificate of waiverOct 6, 2026

National Provider Directory

National Provider Directory

Locations

7101 Etowah St
Altoona, AL 35952
Phone (205) 589-6557

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": "1372118400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1607040000000",
    "number": "1780024679",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 7",
            "city": "ALTOONA",
            "state": "AL",
            "postal_code": "35952",
            "telephone_number": "205-589-6557",
            "fax_number": "205-589-6553"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7101 ETOWAH ST",
            "city": "ALTOONA",
            "state": "AL",
            "postal_code": "35952",
            "telephone_number": "205-589-6557",
            "fax_number": "205-589-6553"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DIXIE INDEPENDENT ENTERPRISES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-06-25",
        "last_updated": "2020-12-04",
        "certification_date": "2020-12-04",
        "status": "A",
        "authorized_official_last_name": "ARGO",
        "authorized_official_first_name": "GABRIEL",
        "authorized_official_title_or_position": "OWER",
        "authorized_official_telephone_number": "205-589-6557",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PHARMD"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": "AL",
            "license": "101165",
            "primary": true
        },
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100001368",
            "state": "AL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Anderson Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Altoona, AL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 4, 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.