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NPI 1811535131

NPI 1811535131 : RONALD GARRETT LAWRENCE RPH : FAYETTE, AL

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General NPI Number Information
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    NPI Number           |    1811535131
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    Entity Type          |    Individual 
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    Provider Name        |    RONALD GARRETT LAWRENCE RPH
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    Gender               |    Male 
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Dates
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    Enumeration Date     |    12/17/2019
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    Last Update Date     |    12/17/2019
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Provider Practice Location Address
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    Address Line         |    1128 2ND AVE NE 
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    City                 |    FAYETTE
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    State                |    AL
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    Zip                  |    35555-1739
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    Country              |    US
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    Telephone            |    205-932-5400
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    Fax                  |    205-932-5401
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Provider Business Mailing Address
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    Address Line         |    1128 2ND AVE NE 
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    City                 |    FAYETTE
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    State                |    AL
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    Zip                  |    35555-1739
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    Country              |    US
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    Telephone            |    205-932-5400
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    Fax                  |    205-932-5401
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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       |    12058
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    License Number State |    AL
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