Provider Demographics
NPI:1699022368
Name:EADY, LAURA ELLIOTT (RPH)
Entity Type:Individual
Prefix:DR
First Name:LAURA
Middle Name:ELLIOTT
Last Name:EADY
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 1:9824 GUERNSEY LN
Mailing Address - Street 2:
Mailing Address - City:TUSCALOOSA
Mailing Address - State:AL
Mailing Address - Zip Code:35405-9756
Mailing Address - Country:US
Mailing Address - Phone:205-342-3320
Mailing Address - Fax:
Practice Address - Street 1:8701 HIGHWAY 69 S
Practice Address - Street 2:
Practice Address - City:TUSCALOOSA
Practice Address - State:AL
Practice Address - Zip Code:35405-8465
Practice Address - Country:US
Practice Address - Phone:205-758-1684
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-08-13
Last Update Date:2012-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL13643183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist