Provider Demographics
NPI:1558686980
Name:SFAKIANOS, TINA MARIE (RPH)
Entity Type:Individual
Prefix:
First Name:TINA
Middle Name:MARIE
Last Name:SFAKIANOS
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1306 BERWICK DR
Mailing Address - Street 2:
Mailing Address - City:BIRMINGHAM
Mailing Address - State:AL
Mailing Address - Zip Code:35242-7114
Mailing Address - Country:US
Mailing Address - Phone:205-991-0470
Mailing Address - Fax:
Practice Address - Street 1:230 19TH ST N
Practice Address - Street 2:
Practice Address - City:BESSEMER
Practice Address - State:AL
Practice Address - Zip Code:35020-4931
Practice Address - Country:US
Practice Address - Phone:205-425-1641
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-03-29
Last Update Date:2010-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL7925183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist