Provider Demographics
NPI:1669565594
Name:ANDREWS, MICKEY RAY (RPH)
Entity type:Individual
Prefix:MR
First Name:MICKEY
Middle Name:RAY
Last Name:ANDREWS
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 1:9024 STURBRIDGE PLACE
Mailing Address - Street 2:
Mailing Address - City:MONTGOMERY
Mailing Address - State:AL
Mailing Address - Zip Code:36116
Mailing Address - Country:US
Mailing Address - Phone:334-272-8935
Mailing Address - Fax:
Practice Address - Street 1:215 PERRY HILL ROAD
Practice Address - Street 2:CENTRAL ALABAMA HEALTH CARE SYSTEM
Practice Address - City:MONTGOMERY
Practice Address - State:AL
Practice Address - Zip Code:36109
Practice Address - Country:US
Practice Address - Phone:334-272-4670
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-10-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL8091183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist