Provider Demographics
NPI:1932285301
Name:EDMONDSON, CHARLOTTE M (PHARM D)
Entity Type:Individual
Prefix:DR
First Name:CHARLOTTE
Middle Name:M
Last Name:EDMONDSON
Suffix:
Gender:F
Credentials:PHARM D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:701 5TH AVE SE
Mailing Address - Street 2:
Mailing Address - City:CULLMAN
Mailing Address - State:AL
Mailing Address - Zip Code:35055-3620
Mailing Address - Country:US
Mailing Address - Phone:256-708-7009
Mailing Address - Fax:
Practice Address - Street 1:561 AL HIGHWAY 69 S
Practice Address - Street 2:
Practice Address - City:HANCEVILLE
Practice Address - State:AL
Practice Address - Zip Code:35077-3403
Practice Address - Country:US
Practice Address - Phone:256-287-9099
Practice Address - Fax:256-287-2817
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-28
Last Update Date:2007-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL14377183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist