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General NPI Number Information
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NPI Number | 1477184588
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Entity Type | Individual
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Provider Name | CHARLES GREGORY HARTLEY II PHARMD
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Gender | Male
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Dates
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Enumeration Date | 01/28/2020
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Last Update Date | 02/26/2025
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Provider Practice Location Address
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Address Line | 4315 GOLF CLUB DR APT 7012
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City | AUBURN
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State | AL
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Zip | 36830-5981
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Country | US
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Telephone | 205-834-0051
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Fax |
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Provider Business Mailing Address
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Address Line | 254 S ANN ST
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City | MOBILE
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State | AL
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Zip | 36604-2326
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Country | US
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Telephone | 205-834-0051
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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 | 22476
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License Number State | AL
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