Provider Demographics
NPI:1467127324
Name:ROSS, MADISON BROOKE (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:MADISON
Middle Name:BROOKE
Last Name:ROSS
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 1:2861 REGAL CIR APT G
Mailing Address - Street 2:
Mailing Address - City:HOOVER
Mailing Address - State:AL
Mailing Address - Zip Code:35216-4661
Mailing Address - Country:US
Mailing Address - Phone:205-544-5715
Mailing Address - Fax:
Practice Address - Street 1:3020 CLAIRMONT AVE S
Practice Address - Street 2:
Practice Address - City:BIRMINGHAM
Practice Address - State:AL
Practice Address - Zip Code:35205-1113
Practice Address - Country:US
Practice Address - Phone:205-323-6823
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-08-12
Last Update Date:2021-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL22052183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist