Provider Demographics
NPI:1972697571
Name:BROOKS, NATASHA (RPH)
Entity type:Individual
Prefix:MS
First Name:NATASHA
Middle Name:
Last Name:BROOKS
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 1:5900 RUSSET MEADOWS WAY
Mailing Address - Street 2:
Mailing Address - City:BIRMINGHAM
Mailing Address - State:AL
Mailing Address - Zip Code:35244
Mailing Address - Country:US
Mailing Address - Phone:205-426-0551
Mailing Address - Fax:205-426-0551
Practice Address - Street 1:215 PERRY HILL ROAD
Practice Address - Street 2:
Practice Address - City:MONTGOMERY
Practice Address - State:AL
Practice Address - Zip Code:36109-3798
Practice Address - Country:US
Practice Address - Phone:334-272-4760
Practice Address - Fax:334-260-4186
Is Sole Proprietor?:No
Enumeration Date:2006-10-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA15773183500000X
AL14700183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist