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NPI Code Detail

MEDICARE: ROSA PETTWAY

MEDICARE: ROSA PETTWAY
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
1183500000XPharmacist15100AL

General Provider Information

NPI Number : 1851405211
Entity Type Code : Individual
Provider Name (Legal Business Name) : ROSA PETTWAY
Provider Business Mailing Address
First Line : RR 2 BOX 66B
Second Line :
City : CAMDEN
State : AL
Zip : 36726-9213
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 583 4TH AVE
Second Line :
City : YORK
State : AL
Zip : 36925-2008
Country : US
Telephone Number : 205-392-5201
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/19/2006
Last Update Date : 07/08/2007

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Directions to “ ROSA PETTWAY ” Practice Location

Language Start Address Practice Location
These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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