Organization
FYFFE PHARMACY, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. BRANDON L. RAINS (OWNER)
(256) 623-2944
Entity
Organization
Contact information
Practice address
44 BLACKWELL ST., FYFFE, AL 35971-0067
(256) 623-2944
(256) 623-3938
Mailing address
PO BOX 67, FYFFE, AL 35971-0067
(256) 623-2944
(256) 623-3938
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
104223
AL
Other
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
Enumeration date
01/26/2007
Last updated
04/28/2008
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