Provider Demographics
NPI:1740709401
Name:WEATHERFORD, DONNA (RPH)
Entity type:Individual
Prefix:
First Name:DONNA
Middle Name:
Last Name:WEATHERFORD
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 1:925 4TH ST NW
Mailing Address - Street 2:
Mailing Address - City:RED BAY
Mailing Address - State:AL
Mailing Address - Zip Code:35582-3953
Mailing Address - Country:US
Mailing Address - Phone:256-356-4044
Mailing Address - Fax:256-356-4045
Practice Address - Street 1:925 4TH ST NW
Practice Address - Street 2:
Practice Address - City:RED BAY
Practice Address - State:AL
Practice Address - Zip Code:35582-3953
Practice Address - Country:US
Practice Address - Phone:256-356-4044
Practice Address - Fax:256-356-4045
Is Sole Proprietor?:Yes
Enumeration Date:2017-09-14
Last Update Date:2017-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL12989183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist