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Organization
SAND DRUG INC
Active
Organization
SAND DRUG INC
Active
Other names
PAYLESS PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
BLAKE LEE GOWEN (PHARMACIST 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
3336L0003X
Long Term Care Pharmacy
Primary
—
NULL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100003745
—
AL
Enumeration date
01/08/2019
Last updated
01/08/2019
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