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General NPI Number Information
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NPI Number | 1073199782
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Entity Type | Individual
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Provider Name | BREANNA NORTH I PHARMD
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Gender | Female
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Dates
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Enumeration Date | 03/23/2021
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Last Update Date | 03/23/2021
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Provider Practice Location Address
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Address Line | 111 E CHURCH ST
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City | COLUMBIA
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State | AL
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Zip | 36319
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Country | US
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Telephone | 334-696-4611
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 614
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City | COLUMBIA
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State | AL
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Zip | 36319-0614
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Country | US
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Telephone | 334-696-4611
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Fax | 334-696-4669
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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 | 14961
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License Number State | AL
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