Provider Demographics
NPI:1689983009
Name:CLEVELAND, CHRISTINE L (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:CHRISTINE
Middle Name:L
Last Name:CLEVELAND
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 1:180 COUNTY ROAD 14
Mailing Address - Street 2:
Mailing Address - City:BELMONT
Mailing Address - State:MS
Mailing Address - Zip Code:38827-8745
Mailing Address - Country:US
Mailing Address - Phone:662-279-9161
Mailing Address - Fax:256-356-4715
Practice Address - Street 1:525 4TH AVENUE SE
Practice Address - Street 2:
Practice Address - City:RED BAY
Practice Address - State:AL
Practice Address - Zip Code:35582
Practice Address - Country:US
Practice Address - Phone:256-356-4540
Practice Address - Fax:256-356-4715
Is Sole Proprietor?:No
Enumeration Date:2010-10-04
Last Update Date:2010-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL15028183500000X
MSE09924183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist