Healthcare Provider Details

I. General information

NPI: 1457567331
Provider Name (Legal Business Name): CHELINDA HALL COTTRELL PHARM D
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/15/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1515 6TH AVE S
BIRMINGHAM AL
35233-1601
US

IV. Provider business mailing address

1301 ROLLING RIDGE CIR
PLEASANT GROVE AL
35127-3532
US

V. Phone/Fax

Practice location:
  • Phone: 205-930-3244
  • Fax: 205-930-3648
Mailing address:
  • Phone: 205-744-9605
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number13083
License Number StateAL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: