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General NPI Number Information
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NPI Number | 1750689709
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Entity Type | Individual
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Provider Name | LACHERYL BRINSON CILLIE
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Gender | Female
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Dates
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Enumeration Date | 02/28/2011
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Last Update Date | 02/28/2011
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Provider Practice Location Address
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Address Line | 2240 ALLENDALE PL
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City | MONTGOMERY
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State | AL
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Zip | 36111-1638
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Country | US
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Telephone | 205-529-4441
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Fax |
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Provider Business Mailing Address
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Address Line | 2300 E SOUTH BLVD
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City | MONTGOMERY
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State | AL
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Zip | 36116-2504
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Country | US
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Telephone | 334-281-1312
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Fax | 334-281-6804
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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 | 11482
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License Number State | AL
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