Healthcare Provider Details

I. General information

NPI: 1336146950
Provider Name (Legal Business Name): DONNIE RAY CALHOUN RPH.
Entity Type: Individual
Gender: Male
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 06/29/2005
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3320 HENRY RD
ANNISTON AL
36207-6344
US

IV. Provider business mailing address

9 REBECCA TRL
ANNISTON AL
36207-7616
US

V. Phone/Fax

Practice location:
  • Phone: 256-236-7611
  • Fax: 256-237-9708
Mailing address:
  • Phone: 256-237-4787
  • Fax: 256-237-9708

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number11150
License Number StateAL
# 2
Primary TaxonomyN
Taxonomy Code183500000X
TaxonomyPharmacist
License Number6979
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: