Misty Candace Stoffregen, RPH

Individual provider Active NPI Pharmacist · Montgomery, AL

NPI 1164514832 · NPPES record last updated Jul 8, 2007

Key facts

NPI
1164514832
Entity type
Individual (NPI type 1)
Primary specialty
Pharmacist 183500000X
License
13657 (AL)
Practice address
5841 Atlanta Hwy
Montgomery, AL 36117-2109
Phone
(334) 277-9676
Fax
(334) 277-9620
NPI assigned
Sep 29, 2006
Sex
Female
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No
Credentials
Registered Pharmacist

State licenses

LicenseStateTypeSpecialty
13657ALMDPharmacist

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 13657 AL Yes

Addresses

Primary practice location

5841 Atlanta Hwy
Montgomery, AL 36117-2109

Mailing address

1477 N Donahue Dr Apt 801
Auburn, AL 36830-0206
Phone (334) 826-6975

Other identifiers

IdentifierTypeStateIssuer
13657OtherALSTATE PHARMACY LICENSE

Other providers in Montgomery, AL

All providers in Montgomery, AL · Pharmacist in Alabama

Sources for this page

Verify at the official NPI Registry.