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NPI Code Detail

MEDICARE: VERONICA LESTER TALLENT PHARMD

MEDICARE: VERONICA LESTER TALLENT PHARMD
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
1183500000XPharmacist084322012AL

General Provider Information

NPI Number : 1811271802
Entity Type Code : Individual
Provider Name (Legal Business Name) : VERONICA LESTER TALLENT PHARMD
Provider Business Mailing Address
First Line : 1613 GLENN BLVD SW
Second Line :
City : FORT PAYNE
State : AL
Zip : 35968-3531
Country : US
Telephone Number : 256-845-0128
Fax Number :
Provider Business Practice Location Address
First Line : 1613 GLENN BLVD SW
Second Line :
City : FORT PAYNE
State : AL
Zip : 35968-3531
Country : US
Telephone Number : 256-845-0128
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/07/2011
Last Update Date : 10/07/2011

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Directions to “ VERONICA LESTER TALLENT PHARMD” Practice Location

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