# FYFFE PHARMACY, LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1043366800
- **Authorized official:** MR. BRANDON L. RAINS (OWNER)
- **Authorized official phone:** (256) 623-2944

## Contact information

- **Practice address:** 44 BLACKWELL ST., FYFFE, AL 35971-0067
- **Practice address phone:** (256) 623-2944
- **Practice address fax:** (256) 623-3938
- **Mailing address:** PO BOX 67, FYFFE, AL 35971-0067
- **Mailing address phone:** (256) 623-2944
- **Mailing address fax:** (256) 623-3938

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 3336C0003X | Community/Retail Pharmacy | 104223 | AL | Yes |

## Other

- **Enumeration date:** 01/26/2007
- **Last updated:** 04/28/2008

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 009911130 | MEDICAID DME | AL |
| 01 | — | 0106852 | NCPDP | AL |
| 05 | — | 100003781 | — | AL |
| 01 | — | 510G730002 | MEDICARE PART B IMMUNIZATION PROVIDER NUMBER | AL |