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General NPI Number Information
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NPI Number | 1205122868
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Entity Type | Individual
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Provider Name | EMILIE B CANTU PHARMD
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Gender | Female
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Dates
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Enumeration Date | 06/22/2011
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Last Update Date | 03/01/2015
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Provider Practice Location Address
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Address Line | 8207 HIGHWAY 72 W
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City | MADISON
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State | AL
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Zip | 35758-9571
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Country | US
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Telephone | 256-690-5891
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Fax | 256-690-5901
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Provider Business Mailing Address
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Address Line | 6275 UNIVERSITY DR NW
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City | HUNTSVILLE
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State | AL
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Zip | 35806-1776
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Country | US
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Telephone | 256-971-0913
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Fax | 256-924-3024
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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 | RPH024910
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License Number State | GA
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Taxonomy #2
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 16969
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License Number State | AL
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