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Individual

MR. CHARLES DANIEL COTTRELL

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
R.PH.

Contact information

Practice address
1121 BELLEVILLE AVE, BREWTON, AL 36426-1500
(251) 867-5454
(251) 867-6117
Mailing address
2110 WILDWOOD DR, BREWTON, AL 36426-2938
(251) 867-5454
(251) 867-6117

Taxonomy

Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
9836
AL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0101775
NABP PHARMACY #
AL
05
10000228
AL
Enumeration date
09/21/2006
Last updated
07/09/2007
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