Provider Demographics
NPI:1417260175
Name:DUBOIS, KIMBERLY L (RPH)
Entity Type:Individual
Prefix:
First Name:KIMBERLY
Middle Name:L
Last Name:DUBOIS
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 1:7880 MOFFETT RD
Mailing Address - Street 2:
Mailing Address - City:SEMMES
Mailing Address - State:AL
Mailing Address - Zip Code:36575-5485
Mailing Address - Country:US
Mailing Address - Phone:251-645-1983
Mailing Address - Fax:251-645-6717
Practice Address - Street 1:7880 MOFFETT RD
Practice Address - Street 2:
Practice Address - City:SEMMES
Practice Address - State:AL
Practice Address - Zip Code:36575-5485
Practice Address - Country:US
Practice Address - Phone:251-645-1983
Practice Address - Fax:251-645-6717
Is Sole Proprietor?:No
Enumeration Date:2010-07-22
Last Update Date:2010-07-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL13725183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist