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General NPI Number Information
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NPI Number | 1073117313
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Entity Type | Individual
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Provider Name | PAYTON ELISE PRIDMORE PHARM.D.
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Gender | Female
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Dates
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Enumeration Date | 11/27/2020
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Last Update Date | 11/27/2020
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Provider Practice Location Address
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Address Line | 4453 OLD SHELL RD
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City | MOBILE
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State | AL
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Zip | 36608-1914
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Country | US
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Telephone | 251-344-9770
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Fax |
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Provider Business Mailing Address
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Address Line | 29962 DOLIVE RDG
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City | SPANISH FORT
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State | AL
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Zip | 36527-8530
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Country | US
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Telephone | 205-534-3535
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 19804
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License Number State | AL
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