Provider Demographics
NPI:1013298900
Name:PRITCHETT, MIKE (PHARMD)
Entity type:Individual
Prefix:MR
First Name:MIKE
Middle Name:
Last Name:PRITCHETT
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4400 UNIVERSITY BLVD E
Mailing Address - Street 2:
Mailing Address - City:TUSCALOOSA
Mailing Address - State:AL
Mailing Address - Zip Code:35404-5104
Mailing Address - Country:US
Mailing Address - Phone:205-553-6188
Mailing Address - Fax:205-553-6348
Practice Address - Street 1:4400 UNIVERSITY BLVD E
Practice Address - Street 2:
Practice Address - City:TUSCALOOSA
Practice Address - State:AL
Practice Address - Zip Code:35404-5104
Practice Address - Country:US
Practice Address - Phone:205-553-6188
Practice Address - Fax:205-553-6348
Is Sole Proprietor?:No
Enumeration Date:2011-09-06
Last Update Date:2011-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL13711183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist