Provider Demographics
NPI:1013358993
Name:CHILDERS, JULIE (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:JULIE
Middle Name:
Last Name:CHILDERS
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2602 FLORENCE BLVD
Mailing Address - Street 2:
Mailing Address - City:FLORENCE
Mailing Address - State:AL
Mailing Address - Zip Code:35630-2864
Mailing Address - Country:US
Mailing Address - Phone:256-764-0436
Mailing Address - Fax:
Practice Address - Street 1:775 PICKWICK ST
Practice Address - Street 2:
Practice Address - City:SAVANNAH
Practice Address - State:TN
Practice Address - Zip Code:38372-3053
Practice Address - Country:US
Practice Address - Phone:731-925-6200
Practice Address - Fax:731-925-1793
Is Sole Proprietor?:No
Enumeration Date:2013-07-09
Last Update Date:2019-12-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL17080183500000X
TN0000037654183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist