Provider Demographics
NPI:1114403441
Name:CURRY, CASSANDRA JOE
Entity Type:Individual
Prefix:
First Name:CASSANDRA
Middle Name:JOE
Last Name:CURRY
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:500 PROVIDENCE MAIN ST NW APT 10302
Mailing Address - Street 2:
Mailing Address - City:HUNTSVILLE
Mailing Address - State:AL
Mailing Address - Zip Code:35806-4895
Mailing Address - Country:US
Mailing Address - Phone:256-468-2049
Mailing Address - Fax:
Practice Address - Street 1:7830 HIGHWAY 72 W
Practice Address - Street 2:
Practice Address - City:MADISON
Practice Address - State:AL
Practice Address - Zip Code:35758-9500
Practice Address - Country:US
Practice Address - Phone:256-864-0511
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-07-19
Last Update Date:2018-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL20496183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist