Provider Demographics
NPI:1508930926
Name:SPEARS, TOMMY C (RPH)
Entity Type:Individual
Prefix:MR
First Name:TOMMY
Middle Name:C
Last Name:SPEARS
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:121 JOHNSON AVE N
Mailing Address - Street 2:
Mailing Address - City:TALLADEGA
Mailing Address - State:AL
Mailing Address - Zip Code:35160-2484
Mailing Address - Country:US
Mailing Address - Phone:256-362-1120
Mailing Address - Fax:256-362-1121
Practice Address - Street 1:121 JOHNSON AVE N
Practice Address - Street 2:
Practice Address - City:TALLADEGA
Practice Address - State:AL
Practice Address - Zip Code:35160-2484
Practice Address - Country:US
Practice Address - Phone:256-362-1120
Practice Address - Fax:256-362-1121
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL9070183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL9070OtherPHARMACIST LICENSE NUMBER