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General NPI Number Information
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NPI Number | 1992190540
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Entity Type | Individual
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Provider Name | TAYLOR JOSEPH DERUITER PHARMD
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Gender | Male
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Dates
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Enumeration Date | 03/31/2015
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Last Update Date | 11/08/2017
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Provider Practice Location Address
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Address Line | 951 SANDSTONE LN
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City | AUBURN
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State | AL
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Zip | 36830-7676
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Country | US
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Telephone | 334-524-3963
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Fax |
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Provider Business Mailing Address
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Address Line | 1761 WIRE RD APT 7-16
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City | AUBURN
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State | AL
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Zip | 36832-6634
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Country | US
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Telephone |
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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 | 19297
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License Number State | AL
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