Provider Demographics
NPI:1215578190
Name:NOLEN, JEFFREY CLAY (PHARMD)
Entity Type:Individual
Prefix:
First Name:JEFFREY
Middle Name:CLAY
Last Name:NOLEN
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:610 PRESERVE PKWY STE 160
Mailing Address - Street 2:
Mailing Address - City:HOOVER
Mailing Address - State:AL
Mailing Address - Zip Code:35226-4250
Mailing Address - Country:US
Mailing Address - Phone:205-332-3888
Mailing Address - Fax:205-961-2999
Practice Address - Street 1:610 PRESERVE PKWY STE 160
Practice Address - Street 2:
Practice Address - City:HOOVER
Practice Address - State:AL
Practice Address - Zip Code:35226-4250
Practice Address - Country:US
Practice Address - Phone:205-332-3888
Practice Address - Fax:205-961-2999
Is Sole Proprietor?:Yes
Enumeration Date:2019-10-02
Last Update Date:2022-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORRPH-0017474183500000X
AL20555183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist