# SAND DRUG INC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** PAY-LESS DRIVE-IN PHARMACY
- **Organization subpart:** No

## Provider details

- **NPI number:** 1154461200
- **Authorized official:** BLAKE LEE GOWEN (OWNER/RPH IN CHARGE)
- **Authorized official phone:** (256) 353-5011

## Contact information

- **Practice address:** 1206 7TH ST SE, DECATUR, AL 35601-3338
- **Practice address phone:** (256) 353-5011
- **Practice address fax:** (256) 355-5152
- **Mailing address:** 1206 7TH ST SE, DECATUR, AL 35601-3338
- **Mailing address phone:** (256) 353-5011
- **Mailing address fax:** (256) 355-5152

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 3336C0003X | Community/Retail Pharmacy | 107541 | AL | Yes |
| 3336C0004X | Compounding Pharmacy | 107541 | AL | — |

## Other

- **Enumeration date:** 02/07/2007
- **Last updated:** 03/07/2023

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 0111790 | NCPDP NUMBER | AL |
| 05 | — | 100003745 | — | AL |
| 01 | — | 107541 | ALABAMA PHARMACY LICENSE | AL |