MEDICARE: MONICA D PAYNE PHARMD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	183500000X	Pharmacist	18849	AL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	18849	OTHER	AL	PHARMACIST LICENSE

General Provider Information

NPI Number	:	1023539228
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MONICA D PAYNE PHARMD

Provider Business Mailing Address
First Line	:	PO BOX 108
Second Line	:
City	:	SECTION
State	:	AL
Zip	:	35771-0108
Country	:	US
Telephone Number	:	256-228-7179
Fax Number	:

Provider Business Practice Location Address
First Line	:	5295 TAMMY LITTLE DRIVE
Second Line	:
City	:	SECTION
State	:	AL
Zip	:	35771-7206
Country	:	US
Telephone Number	:	256-228-7179
Fax Number	:	256-228-4614

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/28/2017
Last Update Date	:	06/28/2017

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Directions to “ MONICA D PAYNE PHARMD” Practice Location

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