Provider Demographics
NPI:1003178039
Name:BIRMINGHAM, ALDRED J (RPH)
Entity Type:Individual
Prefix:
First Name:ALDRED
Middle Name:J
Last Name:BIRMINGHAM
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5995 NOON RD
Mailing Address - Street 2:
Mailing Address - City:BELLINGHAM
Mailing Address - State:WA
Mailing Address - Zip Code:98226-8762
Mailing Address - Country:US
Mailing Address - Phone:360-398-8248
Mailing Address - Fax:
Practice Address - Street 1:1225 W BAKERVIEW RD
Practice Address - Street 2:
Practice Address - City:BELLINGHAM
Practice Address - State:WA
Practice Address - Zip Code:98226-9691
Practice Address - Country:US
Practice Address - Phone:360-788-2933
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-06-14
Last Update Date:2012-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPH 00014654183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist