Healthcare Provider Details

I. General information

NPI: 1013358993
Provider Name (Legal Business Name): JULIE CHILDERS PHARMD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/09/2013
Last Update Date: 12/15/2019
Certification Date: 12/15/2019
Deactivation Date:
Reactivation Date:

III. Provider practice location address

775 PICKWICK ST
SAVANNAH TN
38372-3053
US

IV. Provider business mailing address

2602 FLORENCE BLVD
FLORENCE AL
35630-2864
US

V. Phone/Fax

Practice location:
  • Phone: 731-925-6200
  • Fax: 731-925-1793
Mailing address:
  • Phone: 256-764-0436
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code183500000X
TaxonomyPharmacist
License Number17080
License Number StateAL
# 2
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number0000037654
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: