Provider Demographics
NPI:1689278079
Name:NORMAN, MAX KEITH JR (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:MAX
Middle Name:KEITH
Last Name:NORMAN
Suffix:JR
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:518 TWIN BRANCH DR
Mailing Address - Street 2:
Mailing Address - City:VESTAVIA
Mailing Address - State:AL
Mailing Address - Zip Code:35226-2342
Mailing Address - Country:US
Mailing Address - Phone:334-399-8971
Mailing Address - Fax:205-980-7672
Practice Address - Street 1:5400 HIGHWAY 280
Practice Address - Street 2:
Practice Address - City:HOOVER
Practice Address - State:AL
Practice Address - Zip Code:35242-6508
Practice Address - Country:US
Practice Address - Phone:205-980-7670
Practice Address - Fax:205-980-7672
Is Sole Proprietor?:Yes
Enumeration Date:2020-11-25
Last Update Date:2020-11-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL17391183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist