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NPI Code Detail

MEDICARE: MRS. LISA MURASKI NOLEN R.PH.

MEDICARE: MRS. LISA MURASKI NOLEN R.PH.
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
1183500000XPharmacist12357AL

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
112357OTHERALPHARMACY LICENSE

General Provider Information

NPI Number : 1740385921
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. LISA MURASKI NOLEN R.PH.
Provider Business Mailing Address
First Line : 241 FREEMAN ST
Second Line :
City : DADEVILLE
State : AL
Zip : 36853-1839
Country : US
Telephone Number : 256-825-6104
Fax Number :
Provider Business Practice Location Address
First Line : 1784 ELKAHATCHEE RD
Second Line :
City : ALEXANDER CITY
State : AL
Zip : 35010-4800
Country : US
Telephone Number : 256-234-0091
Fax Number : 256-234-4901
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/13/2006
Last Update Date : 07/08/2007

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