Provider Demographics
NPI:1396363032
Name:IRLE, LEE ANNA (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:LEE
Middle Name:ANNA
Last Name:IRLE
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5380 GAMEPOINT DR
Mailing Address - Street 2:
Mailing Address - City:THEODORE
Mailing Address - State:AL
Mailing Address - Zip Code:36582-7311
Mailing Address - Country:US
Mailing Address - Phone:251-604-8664
Mailing Address - Fax:
Practice Address - Street 1:1 SOUTHERN WAY
Practice Address - Street 2:
Practice Address - City:MOBILE
Practice Address - State:AL
Practice Address - Zip Code:36619-1210
Practice Address - Country:US
Practice Address - Phone:251-544-9500
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-07-09
Last Update Date:2020-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL17028183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist