Provider Demographics
NPI:1003573296
Name:LARUSSA, DEBRA MCCONNELL (RPH)
Entity Type:Individual
Prefix:MS
First Name:DEBRA
Middle Name:MCCONNELL
Last Name:LARUSSA
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:MS
Other - First Name:DEBBIE
Other - Middle Name:MCCONNELL
Other - Last Name:LARUSSA
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:RPH
Mailing Address - Street 1:2000 CENTER POINT PKWY
Mailing Address - Street 2:
Mailing Address - City:BIRMINGHAM
Mailing Address - State:AL
Mailing Address - Zip Code:35215-4620
Mailing Address - Country:US
Mailing Address - Phone:205-853-8001
Mailing Address - Fax:205-853-6879
Practice Address - Street 1:2000 CENTER POINT PKWY
Practice Address - Street 2:
Practice Address - City:BIRMINGHAM
Practice Address - State:AL
Practice Address - Zip Code:35215-4620
Practice Address - Country:US
Practice Address - Phone:205-852-8001
Practice Address - Fax:205-852-6879
Is Sole Proprietor?:No
Enumeration Date:2021-11-22
Last Update Date:2021-11-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL11676183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist