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NPI Code Detail

MEDICARE: MS. PEGGY CALHOUN WILSON RPH

MEDICARE: MS. PEGGY CALHOUN WILSON RPH
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1183500000XPharmacist7136AL

General Provider Information

NPI Number : 1205838505
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. PEGGY CALHOUN WILSON RPH
Provider Business Mailing Address
First Line : 6491 MISTY RIDGE DR
Second Line :
City : BIRMINGHAM
State : AL
Zip : 35235-8659
Country : US
Telephone Number : 205-975-9780
Fax Number : 205-934-7891
Provider Business Practice Location Address
First Line : 619 19TH ST S
Second Line :
City : BIRMINGHAM
State : AL
Zip : 35249-1900
Country : US
Telephone Number : 205-975-9780
Fax Number : 205-934-7891
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/01/2005
Last Update Date : 07/08/2007

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