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General NPI Number Information
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NPI Number | 1295043743
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Entity Type | Individual
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Provider Name | ANDREA SPARKS
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Gender | Female
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Dates
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Enumeration Date | 09/17/2010
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Last Update Date | 01/27/2021
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Provider Practice Location Address
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Address Line | 1501 FLORENCE BLVD
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City | FLORENCE
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State | AL
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Zip | 35630
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Country | US
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Telephone | 256-767-0520
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Fax | 205-485-2633
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Provider Business Mailing Address
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Address Line | 814 20TH ST
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City | HALEYVILLE
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State | AL
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Zip | 35565-1322
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Country | US
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Telephone | 205-486-5888
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Fax | 205-485-2633
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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 | 13240
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License Number State | AL
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