Healthcare Provider Details

I. General information

NPI: 1942356050
Provider Name (Legal Business Name): BILLY RAY POE RPH
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/25/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5324 WINCHESTER RD
NEW MARKET AL
35761-7430
US

IV. Provider business mailing address

5324 WINCHESTER RD
NEW MARKET AL
35761-7430
US

V. Phone/Fax

Practice location:
  • Phone: 256-379-4670
  • Fax: 256-379-4680
Mailing address:
  • Phone: 256-379-4670
  • Fax: 256-379-4680

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number9234
License Number StateAL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: