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Organization
SAND DRUG INC
Active
Organization
SAND DRUG INC
Active
Other names
PAY-LESS DRIVE-IN PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
BLAKE LEE GOWEN (OWNER/RPH IN CHARGE)
(256) 353-5011
Entity
Organization
Contact information
Practice address
1206 7TH ST SE, DECATUR, AL 35601-3338
(256) 353-5011
(256) 355-5152
Mailing address
1206 7TH ST SE, DECATUR, AL 35601-3338
(256) 353-5011
(256) 355-5152
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
107541
AL
3336C0004X
Compounding Pharmacy
107541
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0111790
NCPDP NUMBER
AL
05
—
100003745
—
AL
01
—
107541
ALABAMA PHARMACY LICENSE
AL
Enumeration date
02/07/2007
Last updated
03/07/2023
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