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General NPI Number Information
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NPI Number | 1215453725
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Entity Type | Individual
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Provider Name | CARRIE SEDLAK
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Gender | Female
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Dates
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Enumeration Date | 08/16/2017
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Last Update Date | 08/16/2017
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Provider Practice Location Address
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Address Line | 8701 HIGHWAY 69 S
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City | TUSCALOOSA
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State | AL
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Zip | 35405-8465
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Country | US
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Telephone | 205-758-1684
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Fax |
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Provider Business Mailing Address
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Address Line | 3704 LODGE DR APT J
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City | HOOVER
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State | AL
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Zip | 35216-6299
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Country | US
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Telephone |
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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 | 19961
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License Number State | AL
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