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General NPI Number Information
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NPI Number | 1326512864
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Entity Type | Individual
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Provider Name | SEYED AMINODDIN MIRRAMEZANI
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Gender | Male
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Dates
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Enumeration Date | 01/17/2019
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Last Update Date | 12/10/2021
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Provider Practice Location Address
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Address Line | 8498 MADISON BLVD STE A
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City | MADISON
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State | AL
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Zip | 35758-2049
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Country | US
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Telephone | 256-325-1139
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Fax | 256-325-1159
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Provider Business Mailing Address
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Address Line | 2015 SPARKMAN DR NW
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City | HUNTSVILLE
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State | AL
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Zip | 35810-3815
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Country | US
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Telephone | 256-715-7475
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Fax | 256-715-7418
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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 | 22136
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License Number State | AL
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