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NPI Code Detail

MEDICARE: MRS. MANDY NELSON MULLENIX

MEDICARE: MRS. MANDY NELSON MULLENIX
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
1183500000XPharmacist14183AL

General Provider Information

NPI Number : 1548519978
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. MANDY NELSON MULLENIX
Provider Business Mailing Address
First Line : 3325 UNIVERSITY BLVD E
Second Line :
City : TUSCALOOSA
State : AL
Zip : 35404-4339
Country : US
Telephone Number : 205-556-3800
Fax Number :
Provider Business Practice Location Address
First Line : 3325 UNIVERSITY BLVD E
Second Line :
City : TUSCALOOSA
State : AL
Zip : 35404-4339
Country : US
Telephone Number : 205-556-3800
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/30/2012
Last Update Date : 08/30/2012

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Directions to “ MRS. MANDY NELSON MULLENIX ” Practice Location

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