Provider Demographics
NPI:1245227909
Name:CAPPS, ANGELA LEIGH (RPH)
Entity Type:Individual
Prefix:MRS
First Name:ANGELA
Middle Name:LEIGH
Last Name:CAPPS
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 1:4514 CARROLL ST
Mailing Address - Street 2:
Mailing Address - City:NORTHPORT
Mailing Address - State:AL
Mailing Address - Zip Code:35475-5906
Mailing Address - Country:US
Mailing Address - Phone:205-554-4196
Mailing Address - Fax:205-554-4198
Practice Address - Street 1:1700 UNIVERSITY BLVD E
Practice Address - Street 2:
Practice Address - City:TUSCALOOSA
Practice Address - State:AL
Practice Address - Zip Code:35404-2985
Practice Address - Country:US
Practice Address - Phone:205-554-4196
Practice Address - Fax:205-554-4198
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-09-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL12663183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist