Provider Demographics
NPI:1306190442
Name:FAUST, JANNA (RPH)
Entity Type:Individual
Prefix:
First Name:JANNA
Middle Name:
Last Name:FAUST
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 1:301 2ND AVE W
Mailing Address - Street 2:
Mailing Address - City:ONEONTA
Mailing Address - State:AL
Mailing Address - Zip Code:35121-1607
Mailing Address - Country:US
Mailing Address - Phone:205-274-2740
Mailing Address - Fax:205-274-7444
Practice Address - Street 1:301 2ND AVE W
Practice Address - Street 2:
Practice Address - City:ONEONTA
Practice Address - State:AL
Practice Address - Zip Code:35121-1607
Practice Address - Country:US
Practice Address - Phone:205-274-2740
Practice Address - Fax:205-274-7444
Is Sole Proprietor?:Yes
Enumeration Date:2012-10-26
Last Update Date:2023-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL13545183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist