Provider Demographics
NPI:1558679530
Name:PEEPLES, JIM (RPH)
Entity Type:Individual
Prefix:
First Name:JIM
Middle Name:
Last Name:PEEPLES
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 1:80 RIVER RUN RD
Mailing Address - Street 2:
Mailing Address - City:CHILDERSBURG
Mailing Address - State:AL
Mailing Address - Zip Code:35044-1208
Mailing Address - Country:US
Mailing Address - Phone:256-378-5026
Mailing Address - Fax:256-378-7195
Practice Address - Street 1:80 RIVER RUN RD
Practice Address - Street 2:
Practice Address - City:CHILDERSBURG
Practice Address - State:AL
Practice Address - Zip Code:35044-1208
Practice Address - Country:US
Practice Address - Phone:256-378-5026
Practice Address - Fax:256-378-7195
Is Sole Proprietor?:No
Enumeration Date:2010-09-23
Last Update Date:2010-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL10033183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL10033OtherSTATE OF AL