Individual
JEFFREY MATHIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PHARMACIST
Contact information
Practice address
425 5TH AVE NW, ATTALLA, AL 35954-2214
(245) 413-4455
Mailing address
3257 MONTE DORO DR, VESTAVIA HILLS, AL 35216-4621
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
9971
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
407849878
—
AL
Enumeration date
03/27/2018
Last updated
03/27/2018
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