Provider Demographics
NPI:1689825556
Name:SULLIVAN, KAREEMA DENISE (PHARM D)
Entity Type:Individual
Prefix:
First Name:KAREEMA
Middle Name:DENISE
Last Name:SULLIVAN
Suffix:
Gender:F
Credentials:PHARM D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3903 ATLANTA HWY
Mailing Address - Street 2:
Mailing Address - City:MONTGOMERY
Mailing Address - State:AL
Mailing Address - Zip Code:36109-2918
Mailing Address - Country:US
Mailing Address - Phone:334-277-8253
Mailing Address - Fax:
Practice Address - Street 1:163 HOSPITAL DR
Practice Address - Street 2:
Practice Address - City:TOCCOA
Practice Address - State:GA
Practice Address - Zip Code:30577-6820
Practice Address - Country:US
Practice Address - Phone:706-282-4268
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-10-08
Last Update Date:2021-07-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL000784183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist