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NPI 1366659682

NPI 1366659682 : RORY ELIZABETH COLVIN R.PH. : IDER, AL

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General NPI Number Information
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    NPI Number           |    1366659682
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    Entity Type          |    Individual 
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    Provider Name        |    RORY ELIZABETH COLVIN R.PH.
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    Gender               |    Female 
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Dates
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    Enumeration Date     |    05/17/2007
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    Last Update Date     |    07/08/2007
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Provider Practice Location Address
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    Address Line         |    10705 AL HIGHWAY 75 
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    City                 |    IDER
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    State                |    AL
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    Zip                  |    35981-4627
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    Country              |    US
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    Telephone            |    256-657-5151
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    1400 NORTHRIDGE TRCE 
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    City                 |    ALBERTVILLE
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    State                |    AL
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    Zip                  |    35951-4226
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    Country              |    US
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    Telephone            |    256-891-7887
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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       |    13768
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    License Number State |    AL
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