Healthcare Provider Details

I. General information

NPI: 1326989419
Provider Name (Legal Business Name): EMMA GRACE WOLF
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/02/2026
Last Update Date: 04/02/2026
Certification Date: 04/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

WALKER BLDG 2316, 362 THACH CONCOURSE
AUBURN AL
36849-0001
US

IV. Provider business mailing address

857 HARVARD DR
AUBURN AL
36830-3386
US

V. Phone/Fax

Practice location:
  • Phone: 205-492-5222
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code333600000X
TaxonomyPharmacy
License NumberS14618
License Number StateAL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: