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
—
—
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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