Provider Demographics
NPI:1912312232
Name:CLOUD, PAIGE (PHARM D)
Entity Type:Individual
Prefix:
First Name:PAIGE
Middle Name:
Last Name:CLOUD
Suffix:
Gender:F
Credentials:PHARM D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:275 COUNTY ROAD 596
Mailing Address - Street 2:
Mailing Address - City:STEVENSON
Mailing Address - State:AL
Mailing Address - Zip Code:35772-5590
Mailing Address - Country:US
Mailing Address - Phone:256-495-9300
Mailing Address - Fax:256-495-9301
Practice Address - Street 1:50452 AL HWY 277
Practice Address - Street 2:
Practice Address - City:BRIDGEPORT
Practice Address - State:AL
Practice Address - Zip Code:35740
Practice Address - Country:US
Practice Address - Phone:256-495-9300
Practice Address - Fax:256-495-9301
Is Sole Proprietor?:Yes
Enumeration Date:2014-06-25
Last Update Date:2014-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL17014183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist