Healthcare Provider Details

I. General information

NPI: 1811527328
Provider Name (Legal Business Name): JENNIFER RAMMAGE
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: JENNIFER MCMILLION

II. Dates (important events)

Enumeration Date: 01/23/2020
Last Update Date: 09/02/2022
Certification Date: 09/02/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2515 CRAWFORD RD
PHENIX CITY AL
36867-3629
US

IV. Provider business mailing address

23 NEWBERRY DR
PHENIX CITY AL
36870-8524
US

V. Phone/Fax

Practice location:
  • Phone: 334-297-3722
  • Fax:
Mailing address:
  • Phone: 706-905-1923
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1835P0018X
TaxonomyPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
License Number22724
License Number StateAL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: