Judy Johnson, RPH.
Individual provider Active NPI Pharmacist · Autaugaville, AL
NPI 1235729906 · NPPES record last updated Jan 26, 2021
Key facts
- NPI
- 1235729906
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Pharmacist 183500000X
- License
- 12994 (AL)
- Practice address
- 209 S Washington Street
Autaugaville, AL 36003 - Phone
- (334) 358-1774
- Fax
- (334) 358-1466
- NPI assigned
- Jan 26, 2021
- 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
| License | State | Type | Specialty |
|---|---|---|---|
| 12994 | AL | MD | Pharmacist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 12994 | AL | Yes |
Addresses
Primary practice location
209 S Washington Street
Autaugaville, AL 36003
Mailing address
414 Clear Creek VW
Prattville, AL 36067-6971
Phone (334) 365-1038
Other providers in Autaugaville, AL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 26, 2021. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.