Organization
PAYNES PRESCRIPTION PHARMACY INC
Active
Other names
PAYNES PRESCRIPTION PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
JIM PAYNE (OWNER)
(574) 967-3762
Entity
Organization
Contact information
Practice address
53 S CENTER ST, FLORA, IN 46929-1315
(574) 967-3762
(574) 967-4389
Mailing address
53 S CENTER ST, FLORA, IN 46929-1315
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
60001659A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100294160
—
IN
01
—
1507930
NCPDP PROVIDER IDENTIFICATION NUMBER
—
Enumeration date
08/31/2006
Last updated
03/13/2009
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