Provider Demographics
NPI:1821387184
Name:ATTAWAY, RONNIE EUGENE (RPH)
Entity Type:Individual
Prefix:MR
First Name:RONNIE
Middle Name:EUGENE
Last Name:ATTAWAY
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:915 PARKHILL DR
Mailing Address - Street 2:
Mailing Address - City:TUSCALOOSA
Mailing Address - State:AL
Mailing Address - Zip Code:35404-4473
Mailing Address - Country:US
Mailing Address - Phone:205-310-4879
Mailing Address - Fax:
Practice Address - Street 1:2916 UNIVERSITY BLVD E
Practice Address - Street 2:
Practice Address - City:TUSCALOOSA
Practice Address - State:AL
Practice Address - Zip Code:35404-4246
Practice Address - Country:US
Practice Address - Phone:205-553-0232
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-04-06
Last Update Date:2011-04-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL7162183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist