Healthcare Provider Details

I. General information

NPI: 1639429616
Provider Name (Legal Business Name): JOANNA MARIE HULSEY PHARMD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/17/2012
Last Update Date: 09/17/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

814 20TH ST
HALEYVILLE AL
35565-1322
US

IV. Provider business mailing address

882 SHADY GROVE RD
PHIL CAMPBELL AL
35581-4025
US

V. Phone/Fax

Practice location:
  • Phone: 205-486-5888
  • Fax:
Mailing address:
  • Phone: 205-370-3049
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number16230
License Number StateAL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: