Provider Demographics
NPI:1659420636
Name:HARDWICK, RUSSELL THOMAS SR (RPH)
Entity Type:Individual
Prefix:MR
First Name:RUSSELL
Middle Name:THOMAS
Last Name:HARDWICK
Suffix:SR
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 1:392 GLADE PARK DR
Mailing Address - Street 2:
Mailing Address - City:MONTGOMERY
Mailing Address - State:AL
Mailing Address - Zip Code:36109-1804
Mailing Address - Country:US
Mailing Address - Phone:334-271-2489
Mailing Address - Fax:
Practice Address - Street 1:8251 EASTCHASE PKWY
Practice Address - Street 2:
Practice Address - City:MONTGOMERY
Practice Address - State:AL
Practice Address - Zip Code:36117-7033
Practice Address - Country:US
Practice Address - Phone:334-270-7459
Practice Address - Fax:334-270-7456
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-09
Last Update Date:2015-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL9880183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLPS20306OtherPHARMACIST
GARPH018263OtherPHARMACIST
AL9880OtherPHARMACIST