Healthcare Provider Details
I. General information
NPI: 1740596865
Provider Name (Legal Business Name): CATHERINE SHERRILL LOOSIER PHARMD
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 08/26/2010
Last Update Date: 09/02/2010
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
101 SOUTH UNION STREET SEIB WELLNESS CENTER
MONTGOMERY AL
36104
US
IV. Provider business mailing address
101 SOUTH UNION STREET SEIB WELLNESS CENTER
MONTGOMERY AL
36104
US
V. Phone/Fax
- Phone: 334-263-8464
- Fax:
- Phone: 334-263-8464
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 183500000X |
| Taxonomy | Pharmacist |
| License Number | 19042 |
| License Number State | NC |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 1835P0018X |
| Taxonomy | Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist |
| License Number | 15832 |
| License Number State | AL |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: