Healthcare Provider Details

I. General information

NPI: 1609188135
Provider Name (Legal Business Name): JULIA MAIN PHARM D, RPH
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/13/2010
Last Update Date: 07/13/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

302 PRAIRIE ST N
UNION SPRINGS AL
36089-1417
US

IV. Provider business mailing address

302 PRAIRIE ST N
UNION SPRINGS AL
36089-1417
US

V. Phone/Fax

Practice location:
  • Phone: 334-738-2020
  • Fax: 334-738-8050
Mailing address:
  • Phone: 334-738-2020
  • Fax: 334-738-8050

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number15826
License Number StateAL
# 2
Primary TaxonomyN
Taxonomy Code1835G0303X
TaxonomyGeriatric Pharmacist
License Number15826
License Number StateAL
# 3
Primary TaxonomyN
Taxonomy Code1835P0018X
TaxonomyPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
License Number15826
License Number StateAL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: