Provider Demographics
NPI:1235282195
Name:CIANCIOLA, LANELL (PHARMACIST)
Entity Type:Individual
Prefix:
First Name:LANELL
Middle Name:
Last Name:CIANCIOLA
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:FOX ARMY HEALTH CENTER (CREDENTIALS COORDINATOR)
Mailing Address - Street 2:4100 GOSS ROAD
Mailing Address - City:REDSTONE ARSENAL
Mailing Address - State:AL
Mailing Address - Zip Code:35809-7000
Mailing Address - Country:US
Mailing Address - Phone:256-955-6492
Mailing Address - Fax:256-842-2019
Practice Address - Street 1:FOX ARMY HEALTH CENTER (PHARMACY)
Practice Address - Street 2:4100 GOSS ROAD
Practice Address - City:REDSTONE ARSENAL
Practice Address - State:AL
Practice Address - Zip Code:35809-7000
Practice Address - Country:US
Practice Address - Phone:256-955-8888
Practice Address - Fax:256-955-0189
Is Sole Proprietor?:No
Enumeration Date:2007-01-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL10776183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist