Provider Demographics
NPI:1235400730
Name:HOULIHAN, TAMMERA (RPH)
Entity Type:Individual
Prefix:
First Name:TAMMERA
Middle Name:
Last Name:HOULIHAN
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:30745 ONO NORTH LOOP W
Mailing Address - Street 2:
Mailing Address - City:ORANGE BEACH
Mailing Address - State:AL
Mailing Address - Zip Code:36561-5765
Mailing Address - Country:US
Mailing Address - Phone:931-308-3970
Mailing Address - Fax:
Practice Address - Street 1:25771 PERDIDO BEACH BLVD
Practice Address - Street 2:
Practice Address - City:ORANGE BEACH
Practice Address - State:AL
Practice Address - Zip Code:36561-6107
Practice Address - Country:US
Practice Address - Phone:251-980-1445
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-01-16
Last Update Date:2014-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL16908183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist