Healthcare Provider Details

I. General information

NPI: 1992705057
Provider Name (Legal Business Name): LISA ANN WELDON RPH
Entity Type: Individual
Gender: Female
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 07/29/2005
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2000 6TH AVE S
BIRMINGHAM AL
35233-2110
US

IV. Provider business mailing address

8707 LOCK 17 RD
BESSEMER AL
35023-7103
US

V. Phone/Fax

Practice location:
  • Phone: 205-801-8908
  • Fax: 205-801-8741
Mailing address:
  • Phone: 205-491-2259
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number11223
License Number StateAL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: