Organization Active NPI

Boaz Discount Drugs Inc

  • Community/Retail Pharmacy
  • Boaz, AL
National Provider Identifier
1821092230
Registry record updated Oct 31, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
License
101645 Issued in AL
Legal business name
BOAZ DISCOUNT DRUGS INC
Practice address
10460 Alabama Hwy 168, Suite 1
Boaz, AL 35957-1951
Phone
(256) 593-6546
Fax
(256) 593-3137
NPI assigned
Jun 13, 2005
Last updated
Oct 31, 2011By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 31, 2011

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

Authorized official

Name
Mr. Cary Dale Johnson IIINPI 1962727677
Title
President
Phone
(256) 593-6546

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
Community/Retail Pharmacy 3336C0003X 101645 AL Primary

Addresses

Primary practice location

10460 Alabama Hwy 168, Suite 1
Boaz, AL 35957-1951

Mailing address

PO Box 573
Boaz, AL 35957-0573
Phone (256) 593-6546

Other identifiers 2

IdentifierTypeStateIssuer
0101143OtherALNABP#
100001098MedicaidAL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AL4 enrollments

Enrollment records 4

Enrollment IDStateProvider typePAC IDDetails
O20071015000345 AL Part B Supplier - Mass Immunization (Roster Biller Only) 8921194440 Practice locations: Boaz, AL
O20100930037965 AL DME Supplier - Pharmacy 8921194440 Practice locations: Boaz, AL
O20200622000094 AL Part B Supplier - Independent Clinical Laboratory 8921194440 Practice locations: Boaz, AL
O20200721000295 AL Part B Supplier - Pharmacy 8921194440 Practice locations: Boaz, 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.

Medicare medical equipment & supply locations

SupplierSuppliesMedicare assignment
Boaz Discount Drugs10460 Alabama Hwy 168, Boaz, AL 35957(256) 593-6546 Immunosuppressive Drugs|Nebulizer Drugs|Oral Anticancer Drugs|Blood Glucose Monitors/Supplies (Non-Mail Order)|Orthoses: Off-The-Shelf|Ostomy Supplies|Urological Supplies Accepts assignmentParticipating since Sep 1, 2007

National Provider Directory

National Provider Directory
Tax ID family
Boaz Discount Drugs Inc2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Locations

10402 AL Highway 168
Boaz, AL 35957
Phone (256) 593-6546

10460 AL Highway 168
Ste 1
Boaz, AL 35957
Phone (256) 593-6546

Practitioners & affiliated clinicians

Practitioners 7

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": "1118620800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1320019200000",
    "number": "1821092230",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 573",
            "city": "BOAZ",
            "state": "AL",
            "postal_code": "359570573",
            "telephone_number": "256-593-6546",
            "fax_number": "256-593-3137"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10460 ALABAMA HWY 168, SUITE 1",
            "city": "BOAZ",
            "state": "AL",
            "postal_code": "359571951",
            "telephone_number": "256-593-6546",
            "fax_number": "256-593-3137"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BOAZ DISCOUNT DRUGS INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-06-13",
        "last_updated": "2011-10-31",
        "status": "A",
        "authorized_official_last_name": "JOHNSON",
        "authorized_official_first_name": "CARY",
        "authorized_official_middle_name": "DALE",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "256-593-6546",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_name_suffix": "III"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "AL",
            "license": "101645",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NABP#",
            "identifier": "0101143",
            "state": "AL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100001098",
            "state": "AL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Boaz, AL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 31, 2011; 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.