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NPI Code Detail

MEDICARE: GWEN LYONS PHARMD

MEDICARE: GWEN LYONS 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
1183500000XPharmacist17179AL

General Provider Information

NPI Number : 1518359835
Entity Type Code : Individual
Provider Name (Legal Business Name) : GWEN LYONS PHARMD
Provider Business Mailing Address
First Line : 1086 JEFF RD NW
Second Line :
City : HUNTSVILLE
State : AL
Zip : 35806-1048
Country : US
Telephone Number : 256-721-2751
Fax Number :
Provider Business Practice Location Address
First Line : 1086 JEFF RD NW
Second Line :
City : HUNTSVILLE
State : AL
Zip : 35806-1048
Country : US
Telephone Number : 256-721-2751
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/24/2015
Last Update Date : 02/24/2015

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Directions to “ GWEN LYONS PHARMD” Practice Location

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