Provider Demographics
NPI:1164632824
Name:SELLERS, DEBORAH ANN (PHARMACIST)
Entity Type:Individual
Prefix:
First Name:DEBORAH
Middle Name:ANN
Last Name:SELLERS
Suffix:
Gender:F
Credentials:PHARMACIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:211 ELVIRA AVE
Mailing Address - Street 2:
Mailing Address - City:SATSUMA
Mailing Address - State:AL
Mailing Address - Zip Code:36572-2637
Mailing Address - Country:US
Mailing Address - Phone:251-490-7562
Mailing Address - Fax:251-438-9834
Practice Address - Street 1:1310 SPRING HILL AVE
Practice Address - Street 2:
Practice Address - City:MOBILE
Practice Address - State:AL
Practice Address - Zip Code:36604-3213
Practice Address - Country:US
Practice Address - Phone:251-438-9828
Practice Address - Fax:251-438-9834
Is Sole Proprietor?:No
Enumeration Date:2007-05-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL9178183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist