Provider Demographics
NPI:1932481272
Name:CHAUVIN, VICKI B (RPH)
Entity Type:Individual
Prefix:MRS
First Name:VICKI
Middle Name:B
Last Name:CHAUVIN
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2301 CENTER POINT PKWY
Mailing Address - Street 2:
Mailing Address - City:CENTER POINT
Mailing Address - State:AL
Mailing Address - Zip Code:35215-3618
Mailing Address - Country:US
Mailing Address - Phone:205-853-8360
Mailing Address - Fax:205-853-1834
Practice Address - Street 1:2301 CENTER POINT PKWY
Practice Address - Street 2:
Practice Address - City:CENTER POINT
Practice Address - State:AL
Practice Address - Zip Code:35215-3618
Practice Address - Country:US
Practice Address - Phone:205-853-8360
Practice Address - Fax:205-853-1834
Is Sole Proprietor?:No
Enumeration Date:2011-09-13
Last Update Date:2011-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL9271183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL100003039Medicaid