Provider Demographics
NPI:1861022378
Name:ZNAMENSKI, ANDREI LEONID
Entity Type:Individual
Prefix:
First Name:ANDREI
Middle Name:LEONID
Last Name:ZNAMENSKI
Suffix:
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 1:3403 MILAN DR
Mailing Address - Street 2:
Mailing Address - City:MONTGOMERY
Mailing Address - State:AL
Mailing Address - Zip Code:36109-3711
Mailing Address - Country:US
Mailing Address - Phone:334-782-4800
Mailing Address - Fax:
Practice Address - Street 1:3403 MILAN DR
Practice Address - Street 2:
Practice Address - City:MONTGOMERY
Practice Address - State:AL
Practice Address - Zip Code:36109-3711
Practice Address - Country:US
Practice Address - Phone:334-782-4800
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-01-23
Last Update Date:2022-07-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL22474183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist