Provider Demographics
NPI:1942739529
Name:LEDFORD, CYNTHIA ROSS (RPH)
Entity Type:Individual
Prefix:
First Name:CYNTHIA
Middle Name:ROSS
Last Name:LEDFORD
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 1:306 BROAD ARMSTRONG DR
Mailing Address - Street 2:
Mailing Address - City:BROWNSBORO
Mailing Address - State:AL
Mailing Address - Zip Code:35741-9100
Mailing Address - Country:US
Mailing Address - Phone:256-426-0500
Mailing Address - Fax:
Practice Address - Street 1:8580 HIGHWAY 72 W
Practice Address - Street 2:
Practice Address - City:MADISON
Practice Address - State:AL
Practice Address - Zip Code:35758-9578
Practice Address - Country:US
Practice Address - Phone:256-426-0500
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-06-07
Last Update Date:2017-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL107341835P2201X, 333600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes333600000XSuppliersPharmacy
No1835P2201XPharmacy Service ProvidersPharmacistAmbulatory Care