Healthcare Provider Details

I. General information

NPI: 1376476697
Provider Name (Legal Business Name): DIANA STALLINGS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/05/2026
Last Update Date: 06/05/2026
Certification Date: 06/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3220 5TH AVE S
BIRMINGHAM AL
35222-2309
US

IV. Provider business mailing address

4528 JESSUP LN
HOOVER AL
35226-6603
US

V. Phone/Fax

Practice location:
  • Phone: 205-975-5656
  • Fax:
Mailing address:
  • Phone: 205-527-1301
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number16772
License Number StateAL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: