Provider Demographics
NPI:1184709149
Name:HEDRICK, HEATHER KELLY (PHARMD)
Entity type:Individual
Prefix:DR
First Name:HEATHER
Middle Name:KELLY
Last Name:HEDRICK
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1651 RUBY TYLER PKWY
Mailing Address - Street 2:
Mailing Address - City:TUSCALOOSA
Mailing Address - State:AL
Mailing Address - Zip Code:35404-2990
Mailing Address - Country:US
Mailing Address - Phone:205-507-8115
Mailing Address - Fax:
Practice Address - Street 1:1651 RUBY TYLER PKWY
Practice Address - Street 2:
Practice Address - City:TUSCALOOSA
Practice Address - State:AL
Practice Address - Zip Code:35404-2990
Practice Address - Country:US
Practice Address - Phone:205-507-8115
Practice Address - Fax:205-507-8101
Is Sole Proprietor?:No
Enumeration Date:2006-10-26
Last Update Date:2017-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL149461835P1300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P1300XPharmacy Service ProvidersPharmacistPsychiatric
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL14946OtherPHARMACY LICENSE