Provider Demographics
NPI:1982786414
Name:MYERS, LARRY P (RPH)
Entity Type:Individual
Prefix:MR
First Name:LARRY
Middle Name:P
Last Name:MYERS
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5440 HIGHWAY 90 W
Mailing Address - Street 2:
Mailing Address - City:MOBILE
Mailing Address - State:AL
Mailing Address - Zip Code:36619-4227
Mailing Address - Country:US
Mailing Address - Phone:251-661-0570
Mailing Address - Fax:251-602-1812
Practice Address - Street 1:5440 HIGHWAY 90 W
Practice Address - Street 2:
Practice Address - City:MOBILE
Practice Address - State:AL
Practice Address - Zip Code:36619-4227
Practice Address - Country:US
Practice Address - Phone:251-661-0570
Practice Address - Fax:251-602-1812
Is Sole Proprietor?:No
Enumeration Date:2006-10-20
Last Update Date:2007-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL10133183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist