Provider Demographics
NPI:1811277304
Name:GRIFFIN, LAURA STANFORD (PHARMD)
Entity type:Individual
Prefix:
First Name:LAURA
Middle Name:STANFORD
Last Name:GRIFFIN
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:LAURA
Other - Middle Name:MICHELLE
Other - Last Name:STANFORD
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:847 BOLL WEEVIL CIR
Mailing Address - Street 2:STE 112
Mailing Address - City:ENTERPRISE
Mailing Address - State:AL
Mailing Address - Zip Code:36330-2472
Mailing Address - Country:US
Mailing Address - Phone:334-348-1526
Mailing Address - Fax:334-348-1578
Practice Address - Street 1:847 BOLL WEEVIL CIR
Practice Address - Street 2:STE 112
Practice Address - City:ENTERPRISE
Practice Address - State:AL
Practice Address - Zip Code:36330-2472
Practice Address - Country:US
Practice Address - Phone:334-348-1526
Practice Address - Fax:334-348-1578
Is Sole Proprietor?:Yes
Enumeration Date:2011-08-28
Last Update Date:2015-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARPH026257183500000X
AL17602183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist