Healthcare Provider Details

I. General information

NPI: 1861226359
Provider Name (Legal Business Name): HAYLIE BEHNKE
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/28/2024
Last Update Date: 08/28/2024
Certification Date: 08/28/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1308 TUSCALOOSA AVE SW
BIRMINGHAM AL
35211-1948
US

IV. Provider business mailing address

1010 BEACON PKWY E
BIRMINGHAM AL
35209-3206
US

V. Phone/Fax

Practice location:
  • Phone: 205-679-6325
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number23653
License Number StateAL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: