Healthcare Provider Details

I. General information

NPI: 1285746982
Provider Name (Legal Business Name): CAROL N HUETT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/31/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4035 EASTERN BLVD
MONTGOMERY AL
36116-7308
US

IV. Provider business mailing address

1536 NAFTEL-RAMER RD
RAMER AL
36069-5806
US

V. Phone/Fax

Practice location:
  • Phone: 334-284-6511
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number11487
License Number StateAL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: