1932285301 NPI number — DR. CHARLOTTE M EDMONDSON PHARM D

Table of content: DR. CHARLOTTE M EDMONDSON PHARM D (NPI 1932285301)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1932285301 NPI number — DR. CHARLOTTE M EDMONDSON PHARM D

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
EDMONDSON
Provider First Name:
CHARLOTTE
Provider Middle Name:
M
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:
1932285301
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/23/2007
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
701 5TH AVE SE
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
CULLMAN
Provider Business Mailing Address State Name:
AL
Provider Business Mailing Address Postal Code:
35055-3620
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
256-708-7009
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
561 AL HIGHWAY 69 S
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
HANCEVILLE
Provider Business Practice Location Address State Name:
AL
Provider Business Practice Location Address Postal Code:
35077-3403
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
256-287-9099
Provider Business Practice Location Address Fax Number:
256-287-2817
Provider Enumeration Date:
10/28/2006

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: 183500000X , with the licence number:  14377 , 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)





Copyright © 2007-2025 www.npivalidator.com