Provider Demographics
NPI:1881367274
Name:LOFTIS, MAXANNE WEEKS (RPH)
Entity type:Individual
Prefix:
First Name:MAXANNE
Middle Name:WEEKS
Last Name:LOFTIS
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 1:2405 HIGHWAY 78 E
Mailing Address - Street 2:
Mailing Address - City:JASPER
Mailing Address - State:AL
Mailing Address - Zip Code:35501-3435
Mailing Address - Country:US
Mailing Address - Phone:205-221-2449
Mailing Address - Fax:
Practice Address - Street 1:2405 HIGHWAY 78 E
Practice Address - Street 2:
Practice Address - City:JASPER
Practice Address - State:AL
Practice Address - Zip Code:35501-3435
Practice Address - Country:US
Practice Address - Phone:205-221-2449
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-07-30
Last Update Date:2021-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL116481835X0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835X0200XPharmacy Service ProvidersPharmacistOncology