Provider Demographics
NPI:1689277196
Name:HARTLEY, LADARIA D (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:LADARIA
Middle Name:D
Last Name:HARTLEY
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 1:901 9TH AVE N
Mailing Address - Street 2:
Mailing Address - City:BESSEMER
Mailing Address - State:AL
Mailing Address - Zip Code:35020-5308
Mailing Address - Country:US
Mailing Address - Phone:205-426-1664
Mailing Address - Fax:205-424-3988
Practice Address - Street 1:901 9TH AVE N
Practice Address - Street 2:
Practice Address - City:BESSEMER
Practice Address - State:AL
Practice Address - Zip Code:35020-5308
Practice Address - Country:US
Practice Address - Phone:205-426-1664
Practice Address - Fax:205-424-3988
Is Sole Proprietor?:No
Enumeration Date:2020-11-18
Last Update Date:2020-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL188431835P2201X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P2201XPharmacy Service ProvidersPharmacistAmbulatory Care