Provider Demographics
NPI:1558965871
Name:SANDERS, MARVA CHEELLE (PHARMACIST)
Entity Type:Individual
Prefix:
First Name:MARVA
Middle Name:CHEELLE
Last Name:SANDERS
Suffix:
Gender:F
Credentials:PHARMACIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1910 BELTON AVE
Mailing Address - Street 2:
Mailing Address - City:BESSEMER
Mailing Address - State:AL
Mailing Address - Zip Code:35020-2108
Mailing Address - Country:US
Mailing Address - Phone:205-425-0463
Mailing Address - Fax:
Practice Address - Street 1:418 W VALLEY AVE
Practice Address - Street 2:
Practice Address - City:HOMEWOOD
Practice Address - State:AL
Practice Address - Zip Code:35209-4821
Practice Address - Country:US
Practice Address - Phone:205-942-7503
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-11-27
Last Update Date:2020-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL13826183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist