Provider Demographics
NPI:1043320476
Name:FREEMAN, RITA KAY (RPHARMACIST)
Entity Type:Individual
Prefix:MS
First Name:RITA
Middle Name:KAY
Last Name:FREEMAN
Suffix:
Gender:F
Credentials:RPHARMACIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1701 MAIN AVE SW
Mailing Address - Street 2:SUITE C
Mailing Address - City:CULLMAN
Mailing Address - State:AL
Mailing Address - Zip Code:35055-5299
Mailing Address - Country:US
Mailing Address - Phone:256-737-3773
Mailing Address - Fax:256-737-3775
Practice Address - Street 1:1701 MAIN AVE SW
Practice Address - Street 2:SUITE C
Practice Address - City:CULLMAN
Practice Address - State:AL
Practice Address - Zip Code:35055-5299
Practice Address - Country:US
Practice Address - Phone:256-737-3773
Practice Address - Fax:256-737-3775
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL11205183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL5642050001Medicare ID - Type Unspecified