Healthcare Provider Details

I. General information

NPI: 1912671777
Provider Name (Legal Business Name): DEVAN ROCKWELL PHARMD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/05/2021
Last Update Date: 12/14/2021
Certification Date: 12/14/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1601 CENTER ST
MOBILE AL
36604-1541
US

IV. Provider business mailing address

1601 CENTER ST
MOBILE AL
36604-1541
US

V. Phone/Fax

Practice location:
  • Phone: 251-434-3497
  • Fax:
Mailing address:
  • Phone: 251-434-3475
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberPS60833
License Number StateFL
# 2
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number21585
License Number StateAL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: