Provider Demographics
NPI:1639327117
Name:PETERS, SHARON ELAINE (PHARM D)
Entity type:Individual
Prefix:
First Name:SHARON
Middle Name:ELAINE
Last Name:PETERS
Suffix:
Gender:F
Credentials:PHARM D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:332 NEW HAVEN BLVD
Mailing Address - Street 2:
Mailing Address - City:MONTGOMERY
Mailing Address - State:AL
Mailing Address - Zip Code:36117-6301
Mailing Address - Country:US
Mailing Address - Phone:901-503-6155
Mailing Address - Fax:
Practice Address - Street 1:6995 ATLANTA HWY
Practice Address - Street 2:
Practice Address - City:MONTGOMERY
Practice Address - State:AL
Practice Address - Zip Code:36117-4213
Practice Address - Country:US
Practice Address - Phone:334-396-8415
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-09-08
Last Update Date:2008-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL15874183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist