NPIMap

Organization Active NPI

Odenville Drugs, Inc

  • Pharmacy
  • Odenville, AL
National Provider Identifier
1922045301
Registry record updated Sep 28, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacyTaxonomy code 333600000X
License
112071 Issued in AL
Legal business name
ODENVILLE DRUGS, INC
Practice address
140 Council Dr
Odenville, AL 35120-4495
Phone
(205) 629-6303
Fax
(205) 629-6357
NPI assigned
Jun 2, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 28, 2012

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

Authorized official

Name
Mr. Curtis Marshall Eddy, PHARM DNPI 1588009419
Title
Owner/Pharmacists
Phone
(205) 629-6303

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 2

Specialty (taxonomy)CodeLicenseStatePrimary
Durable Medical Equipment & Medical Supplies 332B00000X 112071 AL
Pharmacy 333600000X 112071 AL Primary

Addresses

Primary practice location

140 Council Dr
Odenville, AL 35120-4495

Mailing address

140 Council Dr
PO Box 787
Odenville, AL 35120-4495
Phone (205) 629-6303

Other identifiers 3

IdentifierTypeStateIssuer
009932217MedicaidAL
0131134OtherALNAPCP NUMBER
100003289MedicaidAL

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20130906000438 AL Part B Supplier - Mass Immunization (Roster Biller Only) 3476796681 Practice locations: Odenville, 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
01D2059295Odenville Drugs140 Council Drive, Odenville, AL 35120Certificate of waiverMay 20, 2027

National Provider Directory

National Provider Directory

Locations

140 Council Dr
Odenville, AL 35120
Phone (205) 629-6303

Practitioners & affiliated clinicians

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1149206400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1348790400000",
    "number": "1922045301",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "140 COUNCIL DR",
            "address_2": "PO BOX 787",
            "city": "ODENVILLE",
            "state": "AL",
            "postal_code": "351204495",
            "telephone_number": "205-629-6303",
            "fax_number": "205-629-6357"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "140 COUNCIL DR",
            "city": "ODENVILLE",
            "state": "AL",
            "postal_code": "351204495",
            "telephone_number": "205-629-6303",
            "fax_number": "205-629-6357"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ODENVILLE DRUGS, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-02",
        "last_updated": "2012-09-28",
        "status": "A",
        "authorized_official_last_name": "EDDY",
        "authorized_official_first_name": "CURTIS",
        "authorized_official_middle_name": "MARSHALL",
        "authorized_official_title_or_position": "OWNER/PHARMACISTS",
        "authorized_official_telephone_number": "205-629-6303",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "PHARM D"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "AL",
            "license": "112071",
            "primary": false
        },
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": "AL",
            "license": "112071",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "009932217",
            "state": "AL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NAPCP NUMBER",
            "identifier": "0131134",
            "state": "AL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100003289",
            "state": "AL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Odenville, AL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 28, 2012; 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.