Provider Demographics
NPI:1851987994
Name:MCMANUS, ALBERT MILLER II
Entity Type:Individual
Prefix:
First Name:ALBERT
Middle Name:MILLER
Last Name:MCMANUS
Suffix:II
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:210 WEST FRONT ST
Mailing Address - Street 2:
Mailing Address - City:EVERGREEN
Mailing Address - State:AL
Mailing Address - Zip Code:36401
Mailing Address - Country:US
Mailing Address - Phone:251-578-2227
Mailing Address - Fax:251-578-9694
Practice Address - Street 1:210 W FRONT ST
Practice Address - Street 2:
Practice Address - City:EVERGREEN
Practice Address - State:AL
Practice Address - Zip Code:36401-2815
Practice Address - Country:US
Practice Address - Phone:251-578-2227
Practice Address - Fax:251-578-9694
Is Sole Proprietor?:Yes
Enumeration Date:2020-12-13
Last Update Date:2020-12-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL66383336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy