Individual
STACY BOUCHER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PHARMD
Contact information
Practice address
181 HIGHWAY 84 W, DALEVILLE, AL 36322-9113
(334) 598-4242
(334) 598-4240
Mailing address
181 HIGHWAY 84 W, DALEVILLE, AL 36322-9113
(334) 598-4242
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
14575
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
14575
ALABAMA STATE BOARD OF PHARMACY
AL
Enumeration date
11/20/2020
Last updated
11/20/2020
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