Payless at Fred'S Inc

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

110617 Issued in AL

Legal business name

PAYLESS AT FRED'S INC

Practice address

29930 Ardmore Avenue
Ardmore, AL 35739-7450

Phone

(256) 423-8989

Fax

(256) 423-8990

NPI assigned

May 26, 2016

Organization subpart

No

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

Authorized official

Name

Nick W Holland, AUTHORIZED OFFICIAL

Title

Owner

Phone

(256) 423-2680

Specialties & licenses 2

Addresses

Other identifiers 1

Other names 1

• Payless at Freds Doing business as

Tax ID family

Payless Pharmacy3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

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

• Payless Pharmacy

  • Pharmacist
  • Ardmore, AL
  • NPI 1164578514
  NPD tax ID
• Payless Pharmacy

  • Durable Medical Equipment & Medical Supplies
  • Ardmore, AL
  • NPI 1174766018
  NPD tax ID

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

{
    "created_epoch": "1464220800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1464220800000",
    "number": "1912355231",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "P.O. BOX 566",
            "city": "ARDMORE",
            "state": "TN",
            "postal_code": "384490429",
            "telephone_number": "256-423-8969",
            "fax_number": "256-423-8990"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "29930 ARDMORE AVENUE",
            "city": "ARDMORE",
            "state": "AL",
            "postal_code": "357397450",
            "telephone_number": "256-423-8989",
            "fax_number": "256-423-8990"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PAYLESS AT FRED'S INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-05-26",
        "last_updated": "2016-05-26",
        "status": "A",
        "authorized_official_last_name": "HOLLAND",
        "authorized_official_first_name": "NICK",
        "authorized_official_middle_name": "W",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "256-423-2680",
        "authorized_official_credential": "AUTHORIZED OFFICIAL"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "AL",
            "license": "110617",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100002271",
            "state": "AL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Payless at Freds",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 26, 2016; 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.