Healthcare Provider Details

I. General information

NPI: 1699435776
Provider Name (Legal Business Name): LILIAN AUMA OKUMU PHARMD.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/30/2021
Last Update Date: 12/30/2021
Certification Date: 12/29/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7090 HIGHWAY 72 W
HUNTSVILLE AL
35806-1728
US

IV. Provider business mailing address

2150 HUGHES RD UNIT 1401
MADISON AL
35758-6441
US

V. Phone/Fax

Practice location:
  • Phone: 256-726-0610
  • Fax: 256-726-0615
Mailing address:
  • Phone: 334-421-0061
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1835P0018X
TaxonomyPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
License Number22183
License Number StateAL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: