Healthcare Provider Details

I. General information

NPI: 1023121191
Provider Name (Legal Business Name): MICHEAL ALAN POWERS RPH
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/15/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13574 HIGHWAY 231 431 N STE B
HAZEL GREEN AL
35750-8642
US

IV. Provider business mailing address

104 CLEAR SPRINGS CIR
HAZEL GREEN AL
35750-4601
US

V. Phone/Fax

Practice location:
  • Phone: 256-813-0150
  • Fax: 256-813-0149
Mailing address:
  • Phone: 256-828-9540
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number11561
License Number StateAL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: