Provider Demographics
NPI:1659459535
Name:COONS, WILLIAM A (RPH)
Entity Type:Individual
Prefix:
First Name:WILLIAM
Middle Name:A
Last Name:COONS
Suffix:
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:PO BOX 486
Mailing Address - Street 2:26289 HWY 195
Mailing Address - City:DOUBLE SPRINGS
Mailing Address - State:AL
Mailing Address - Zip Code:35553-0486
Mailing Address - Country:US
Mailing Address - Phone:205-489-2572
Mailing Address - Fax:205-489-3722
Practice Address - Street 1:26289 HWY 195
Practice Address - Street 2:
Practice Address - City:DOUBLE SPRINGS
Practice Address - State:AL
Practice Address - Zip Code:35553-0486
Practice Address - Country:US
Practice Address - Phone:205-489-2572
Practice Address - Fax:205-489-3722
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL104330183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist