Provider Demographics
NPI:1588998082
Name:DORA DISCOUNT PHARMACY, INC
Entity type:Organization
Organization Name:DORA DISCOUNT PHARMACY, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SUPERVISING PHARMACIST/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:CHRISTOPHER
Authorized Official - Last Name:HENSLEE
Authorized Official - Suffix:
Authorized Official - Credentials:PHARMD
Authorized Official - Phone:205-648-4292
Mailing Address - Street 1:2165 HIGHWAY 78
Mailing Address - Street 2:SUITE 102
Mailing Address - City:DORA
Mailing Address - State:AL
Mailing Address - Zip Code:35062-4548
Mailing Address - Country:US
Mailing Address - Phone:205-648-4292
Mailing Address - Fax:205-648-4262
Practice Address - Street 1:2165 HIGHWAY 78
Practice Address - Street 2:SUITE 102
Practice Address - City:DORA
Practice Address - State:AL
Practice Address - Zip Code:35062-4548
Practice Address - Country:US
Practice Address - Phone:205-936-1999
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-09-30
Last Update Date:2024-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL150763336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL114770Medicaid