Provider Demographics
NPI:1205050390
Name:ANDERSON, CRAIG HOPKINS (RPH)
Entity type:Individual
Prefix:MR
First Name:CRAIG
Middle Name:HOPKINS
Last Name:ANDERSON
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:224 BROOKSIDE DR
Mailing Address - Street 2:
Mailing Address - City:KILLEN
Mailing Address - State:AL
Mailing Address - Zip Code:35645-8806
Mailing Address - Country:US
Mailing Address - Phone:256-446-6527
Mailing Address - Fax:256-446-2585
Practice Address - Street 1:2230 RAILROAD ST
Practice Address - Street 2:
Practice Address - City:LEIGHTON
Practice Address - State:AL
Practice Address - Zip Code:35646-3819
Practice Address - Country:US
Practice Address - Phone:256-446-6527
Practice Address - Fax:256-446-2585
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ALAL10454183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist