Individual
DR. TIVANKA SANJEA DESILVA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PHARMD
Contact information
Practice address
1052 PINE VALLEY DR, CALERA, AL 35040-4710
(205) 744-9972
Mailing address
1052 PINE VALLEY DR, CALERA, AL 35040-4710
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
16306
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100003308
—
AL
Enumeration date
12/07/2011
Last updated
12/07/2011
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