Provider Demographics
NPI:1043628035
Name:OLIN, BERNIE RALPH III (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:BERNIE
Middle Name:RALPH
Last Name:OLIN
Suffix:III
Gender:M
Credentials:PHARMD
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Other - Credentials:
Mailing Address - Street 1:362 W THACH CONCOURSE
Mailing Address - Street 2:1323 WALKER BUILDING
Mailing Address - City:AUBURN
Mailing Address - State:AL
Mailing Address - Zip Code:36849-0001
Mailing Address - Country:US
Mailing Address - Phone:334-844-8334
Mailing Address - Fax:334-844-4410
Practice Address - Street 1:362 W THACH CONCOURSE
Practice Address - Street 2:1323 WALKER BUILDING
Practice Address - City:AUBURN
Practice Address - State:AL
Practice Address - Zip Code:36849-0001
Practice Address - Country:US
Practice Address - Phone:334-844-8334
Practice Address - Fax:334-844-4410
Is Sole Proprietor?:Yes
Enumeration Date:2014-07-23
Last Update Date:2014-07-23
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
AL149641835P1200X
KS1-093781835P1200X
MO0288481835P1200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P1200XPharmacy Service ProvidersPharmacistPharmacotherapy