Provider Demographics
NPI:1891008702
Name:STILL, CHARLES MARVIN (RPH)
Entity Type:Individual
Prefix:MR
First Name:CHARLES
Middle Name:MARVIN
Last Name:STILL
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 1:1011 PERRY HILL RD
Mailing Address - Street 2:
Mailing Address - City:MONTGOMERY
Mailing Address - State:AL
Mailing Address - Zip Code:36109-4521
Mailing Address - Country:US
Mailing Address - Phone:334-270-0660
Mailing Address - Fax:334-273-7971
Practice Address - Street 1:1011 PERRY HILL RD
Practice Address - Street 2:
Practice Address - City:MONTGOMERY
Practice Address - State:AL
Practice Address - Zip Code:36109-4521
Practice Address - Country:US
Practice Address - Phone:334-270-0660
Practice Address - Fax:334-273-7971
Is Sole Proprietor?:Yes
Enumeration Date:2010-07-20
Last Update Date:2010-07-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL7571183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist