Healthcare Provider Details

I. General information

NPI: 1083701353
Provider Name (Legal Business Name): MONICA P SFAKIANOS R.PH.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/06/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

700 19TH ST S
BIRMINGHAM AL
35233-1927
US

IV. Provider business mailing address

700 SOUTH 19TH STREET
BIRMINGHAM AL
35233
US

V. Phone/Fax

Practice location:
  • Phone: 205-918-3249
  • Fax: 205-558-4784
Mailing address:
  • Phone: 205-918-3249
  • Fax: 205-558-4784

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number7211
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: