Individual
DERRICK AUSTIN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
64 GILES ST, HEFLIN, AL 36264-1738
(256) 393-4063
(256) 463-2026
Mailing address
64 GILES ST, HEFLIN, AL 36264-1738
(256) 393-4063
(256) 463-2026
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
10984
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
10984
ALBAMA LICENSE NUMBER
AL
Enumeration date
12/03/2014
Last updated
02/04/2015
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