Healthcare Provider Details

I. General information

NPI: 1366555013
Provider Name (Legal Business Name): TAMMY V GARRETT
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/16/2006
Last Update Date: 03/17/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11964 ESCUE DR STE A
TANNER AL
35671-3680
US

IV. Provider business mailing address

11234 DRENNEN DR
TANNER AL
35671-3622
US

V. Phone/Fax

Practice location:
  • Phone: 256-232-6588
  • Fax: 256-232-6589
Mailing address:
  • Phone: 256-232-6588
  • Fax: 256-232-6589

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code183500000X
TaxonomyPharmacist
License Number111155
License Number StateAL
# 2
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number11095
License Number StateAL

VIII. Authorized Official

Name: TAMMY V GARRETT
Title or Position: OWNER/PIC
Credential: RPH
Phone: 256-232-6588