Provider Demographics
NPI:1043521701
Name:JEFFREYS, MARY KATHERINE (PHARM D)
Entity Type:Individual
Prefix:
First Name:MARY
Middle Name:KATHERINE
Last Name:JEFFREYS
Suffix:
Gender:F
Credentials:PHARM D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1627 MANHATTAN ST
Mailing Address - Street 2:
Mailing Address - City:HOMEWOOD
Mailing Address - State:AL
Mailing Address - Zip Code:35209-2313
Mailing Address - Country:US
Mailing Address - Phone:251-404-8760
Mailing Address - Fax:
Practice Address - Street 1:1627 MANHATTAN ST
Practice Address - Street 2:
Practice Address - City:HOMEWOOD
Practice Address - State:AL
Practice Address - Zip Code:35209-2313
Practice Address - Country:US
Practice Address - Phone:251-404-8760
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-06-28
Last Update Date:2010-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL16459183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist