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Individual

DR. ERIC VICTOR SHORT

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
PHARM.D.

Contact information

Practice address
83 MAIN ST, CORDOVA, AL 35550-1414
(205) 648-9918
(205) 648-9644
Mailing address
83 MAIN ST, CORDOVA, AL 35550-1414
(205) 648-9918
(205) 648-9644

Taxonomy

Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
13847
AL
1835P1200X
Pharmacotherapy Pharmacist
13847
AL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
13847
PHARMACY LICENSE NUMBER
AL
Enumeration date
02/05/2009
Last updated
02/05/2009
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