Provider Demographics
NPI:1437268273
Name:BALLARD, BELINDA P (RPH)
Entity Type:Individual
Prefix:MS
First Name:BELINDA
Middle Name:P
Last Name:BALLARD
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:MISS
Other - First Name:BELINDA
Other - Middle Name:K
Other - Last Name:PITTS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 945
Mailing Address - Street 2:
Mailing Address - City:STEVENSON
Mailing Address - State:AL
Mailing Address - Zip Code:35772-0945
Mailing Address - Country:US
Mailing Address - Phone:256-608-8833
Mailing Address - Fax:
Practice Address - Street 1:CO RD 350
Practice Address - Street 2:
Practice Address - City:STEVENSON
Practice Address - State:AL
Practice Address - Zip Code:35772
Practice Address - Country:US
Practice Address - Phone:256-608-8833
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-29
Last Update Date:2013-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL10506183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist