Provider Demographics
NPI:1902630668
Name:IDER DISCOUNT DRUGS INC
Entity type:Organization
Organization Name:IDER DISCOUNT DRUGS INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:FRANK
Authorized Official - Middle Name:B
Authorized Official - Last Name:TANT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:256-463-2197
Mailing Address - Street 1:10705 AL HIGHWAY 75
Mailing Address - Street 2:
Mailing Address - City:IDER
Mailing Address - State:AL
Mailing Address - Zip Code:35981-4627
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:10705 AL HIGHWAY 75
Practice Address - Street 2:
Practice Address - City:IDER
Practice Address - State:AL
Practice Address - Zip Code:35981-4627
Practice Address - Country:US
Practice Address - Phone:877-651-8006
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-08-27
Last Update Date:2024-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336L0003XSuppliersPharmacyLong Term Care Pharmacy