Healthcare Provider Details

I. General information

NPI: 1699860247
Provider Name (Legal Business Name): CORRINA L WILLIAMS PHARMD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/03/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1661 LEE ST
ROGERSVILLE AL
35652
US

IV. Provider business mailing address

210 CO RD 51
ROGERSVILLE AL
35652
US

V. Phone/Fax

Practice location:
  • Phone: 256-247-5451
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number15296
License Number StateAL
# 2
Primary TaxonomyN
Taxonomy Code183500000X
TaxonomyPharmacist
License Number27470
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: