Healthcare Provider Details

I. General information

NPI: 1780500496
Provider Name (Legal Business Name): TIFFANY LEWIS PHARMD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/26/2026
Last Update Date: 06/26/2026
Certification Date: 06/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3686 GRANDVIEW PKWY STE 120
BIRMINGHAM AL
35243-3334
US

IV. Provider business mailing address

3686 GRANDVIEW PKWY STE 120
BIRMINGHAM AL
35243-3334
US

V. Phone/Fax

Practice location:
  • Phone: 205-595-0419
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number24551
License Number StateAL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: