Healthcare Provider Details

I. General information

NPI: 1447806062
Provider Name (Legal Business Name): WALTER ALEXANDER MEADOWS PHARMD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/11/2019
Last Update Date: 07/28/2022
Certification Date: 07/28/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2300 GUNTER AVE
GUNTERSVILLE AL
35976-2238
US

IV. Provider business mailing address

2300 GUNTER AVE
GUNTERSVILLE AL
35976-2238
US

V. Phone/Fax

Practice location:
  • Phone: 256-571-2506
  • Fax:
Mailing address:
  • Phone: 256-571-2506
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number22648
License Number StateAL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: