Healthcare Provider Details

I. General information

NPI: 1932285301
Provider Name (Legal Business Name): CHARLOTTE M EDMONDSON PHARM D
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/28/2006
Last Update Date: 07/23/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

561 AL HIGHWAY 69 S
HANCEVILLE AL
35077-3403
US

IV. Provider business mailing address

701 5TH AVE SE
CULLMAN AL
35055-3620
US

V. Phone/Fax

Practice location:
  • Phone: 256-287-9099
  • Fax: 256-287-2817
Mailing address:
  • Phone: 256-708-7009
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number14377
License Number StateAL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: