Provider Demographics
NPI:1568807444
Name:BUNN, CANDICE RUSTON (PHARMD)
Entity Type:Individual
Prefix:MRS
First Name:CANDICE
Middle Name:RUSTON
Last Name:BUNN
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 1:4861 STONECREEK WAY
Mailing Address - Street 2:
Mailing Address - City:CALERA
Mailing Address - State:AL
Mailing Address - Zip Code:35040-7609
Mailing Address - Country:US
Mailing Address - Phone:205-516-7879
Mailing Address - Fax:
Practice Address - Street 1:90 MARKETPLACE CIR
Practice Address - Street 2:
Practice Address - City:CALERA
Practice Address - State:AL
Practice Address - Zip Code:35040-8200
Practice Address - Country:US
Practice Address - Phone:205-668-3590
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-05-06
Last Update Date:2016-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ALS10639390200000X
AL19466183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program