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General NPI Number Information
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NPI Number | 1982730222
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Entity Type | Individual
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Provider Name | JEFFREY G CHURCH R.PH.
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Gender | Male
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Dates
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Enumeration Date | 02/23/2007
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Last Update Date | 08/20/2020
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Provider Practice Location Address
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Address Line | 5611 SHIRLEY PARK DR
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City | BESSEMER
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State | AL
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Zip | 35022-3402
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Country | US
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Telephone | 205-547-3964
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Fax | 205-484-0552
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Provider Business Mailing Address
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Address Line | 1027 GRAND OAKS DRIVE
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City | BESSEMER
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State | AL
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Zip | 35022
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Country | US
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Telephone | 205-746-4549
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Fax | 205-978-9377
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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 | 12930
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License Number State | AL
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