1598059834 NPI number — DR. BYRDENA DEEANN DUGAN PHARM.D.

Table of content: DR. BYRDENA DEEANN DUGAN PHARM.D. (NPI 1598059834)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1598059834 NPI number — DR. BYRDENA DEEANN DUGAN PHARM.D.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
DUGAN
Provider First Name:
BYRDENA
Provider Middle Name:
DEEANN
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
PHARM.D.
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1598059834
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
06/03/2011
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
800 LAKESHORE DR
Provider Second Line Business Mailing Address:
MCWHORTER SCHOOL OF PHARMACY
Provider Business Mailing Address City Name:
BIRMINGHAM
Provider Business Mailing Address State Name:
AL
Provider Business Mailing Address Postal Code:
35229-0001
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
205-726-2635
Provider Business Mailing Address Fax Number:
205-726-2669

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
800 LAKESHORE DR
Provider Second Line Business Practice Location Address:
MCWHORTER SCHOOL OF PHARMACY
Provider Business Practice Location Address City Name:
BIRMINGHAM
Provider Business Practice Location Address State Name:
AL
Provider Business Practice Location Address Postal Code:
35229-0001
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
205-726-2635
Provider Business Practice Location Address Fax Number:
205-726-2669
Provider Enumeration Date:
06/03/2011

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 1835P0018X , with the licence number:  15974 , registered in the state of AL ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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