Provider Demographics
NPI:1720115918
Name:TRAMMELL, CYNTHIA JUSTICE (RPH)
Entity Type:Individual
Prefix:MRS
First Name:CYNTHIA
Middle Name:JUSTICE
Last Name:TRAMMELL
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1888 HIGHWAY 2
Mailing Address - Street 2:
Mailing Address - City:WESTVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32464-3024
Mailing Address - Country:US
Mailing Address - Phone:850-956-2208
Mailing Address - Fax:
Practice Address - Street 1:501 S COMMERCE ST
Practice Address - Street 2:
Practice Address - City:GENEVA
Practice Address - State:AL
Practice Address - Zip Code:36340-2420
Practice Address - Country:US
Practice Address - Phone:334-684-2272
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-02-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL12213183500000X
FLPS 26077183500000X
FLPU 4367183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist