Provider Demographics
NPI:1598960759
Name:HIGGINS, LISA C (RPH)
Entity Type:Individual
Prefix:MRS
First Name:LISA
Middle Name:C
Last Name:HIGGINS
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 1:2345 FARLEY PL
Mailing Address - Street 2:
Mailing Address - City:HOOVER
Mailing Address - State:AL
Mailing Address - Zip Code:35226-1415
Mailing Address - Country:US
Mailing Address - Phone:205-823-1559
Mailing Address - Fax:205-941-0242
Practice Address - Street 1:126 WILDWOOD PKWY
Practice Address - Street 2:
Practice Address - City:BIRMINGHAM
Practice Address - State:AL
Practice Address - Zip Code:35209-7153
Practice Address - Country:US
Practice Address - Phone:205-940-9037
Practice Address - Fax:205-941-0242
Is Sole Proprietor?:No
Enumeration Date:2007-06-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL10869183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL515-38508OtherBCBS MTMP PROVIDER NUMBER