Provider Demographics
NPI:1699013920
Name:SUMMERS, BARBRA E (RPH)
Entity Type:Individual
Prefix:
First Name:BARBRA
Middle Name:E
Last Name:SUMMERS
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 1:4236 WATERFORD LN
Mailing Address - Street 2:
Mailing Address - City:TRUSSVILLE
Mailing Address - State:AL
Mailing Address - Zip Code:35173-1587
Mailing Address - Country:US
Mailing Address - Phone:205-862-8879
Mailing Address - Fax:
Practice Address - Street 1:4236 WATERFORD LN
Practice Address - Street 2:
Practice Address - City:TRUSSVILLE
Practice Address - State:AL
Practice Address - Zip Code:35173-1587
Practice Address - Country:US
Practice Address - Phone:205-862-8879
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-01-21
Last Update Date:2013-01-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL14288183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist