Provider Demographics
NPI:1689743148
Name:PARKER, PATRICE W (RPH)
Entity Type:Individual
Prefix:
First Name:PATRICE
Middle Name:W
Last Name:PARKER
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 1:7616 LAKESHORE DR
Mailing Address - Street 2:
Mailing Address - City:MC CALLA
Mailing Address - State:AL
Mailing Address - Zip Code:35111-3232
Mailing Address - Country:US
Mailing Address - Phone:205-477-9536
Mailing Address - Fax:205-995-4965
Practice Address - Street 1:2653 VALLEYDALE RD
Practice Address - Street 2:
Practice Address - City:BIRMINGHAM
Practice Address - State:AL
Practice Address - Zip Code:35244-2026
Practice Address - Country:US
Practice Address - Phone:205-995-4960
Practice Address - Fax:205-995-4965
Is Sole Proprietor?:No
Enumeration Date:2006-11-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL13404183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist