Provider Demographics
NPI:1497050389
Name:LEWIS, ANGELA L (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:ANGELA
Middle Name:L
Last Name:LEWIS
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 1:725 E COY SMITH HWY
Mailing Address - Street 2:P.O. BOX 1090
Mailing Address - City:MOUNT VERNON
Mailing Address - State:AL
Mailing Address - Zip Code:36560-3322
Mailing Address - Country:US
Mailing Address - Phone:251-662-6700
Mailing Address - Fax:251-829-5636
Practice Address - Street 1:725 E COY SMITH HWY
Practice Address - Street 2:
Practice Address - City:MOUNT VERNON
Practice Address - State:AL
Practice Address - Zip Code:36560-3322
Practice Address - Country:US
Practice Address - Phone:251-662-6700
Practice Address - Fax:251-829-5636
Is Sole Proprietor?:Yes
Enumeration Date:2011-01-24
Last Update Date:2011-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL149271835P1300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P1300XPharmacy Service ProvidersPharmacistPsychiatric