Healthcare Provider Details

I. General information

NPI: 1538249867
Provider Name (Legal Business Name): RUTH ANN DEAN RPH
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/17/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9082 MOFFETT RD WINN-DIXIE PHARMACY
SEMMES AL
36575-5242
US

IV. Provider business mailing address

1320 REVERE CT
MOBILE AL
36695-3556
US

V. Phone/Fax

Practice location:
  • Phone: 251-649-0663
  • Fax: 251-649-6698
Mailing address:
  • Phone: 251-633-4177
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number7585
License Number StateAL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: