Healthcare Provider Details

I. General information

NPI: 1891089900
Provider Name (Legal Business Name): LISA WOODS HARRIS PHARMD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/06/2011
Last Update Date: 06/06/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3489 LOWERY PKWY T-2355
FULTONDALE AL
35068-1677
US

IV. Provider business mailing address

3489 LOWERY PKWY T-2355
FULTONDALE AL
35068-1677
US

V. Phone/Fax

Practice location:
  • Phone: 205-453-6033
  • Fax:
Mailing address:
  • Phone: 205-453-6033
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number15229
License Number StateAL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: