Tabitha J Averette, RPH
Individual provider Active NPI Pharmacist · Maplesville, AL
NPI 1487716627 · NPPES record last updated Jul 8, 2007
Key facts
- NPI
- 1487716627
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Pharmacist 183500000X
- License
- 109598 (AL)
- Practice address
- 9081 Hwy 22
Maplesville, AL 36750-0141 - Phone
- (334) 366-2425
- Fax
- (334) 366-2456
- NPI assigned
- Dec 14, 2006
- Sex
- Female
- Sole proprietor
- Yes
Organizations & group practices 2
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 |
|---|---|---|---|
| 109598 | AL | MD | Pharmacist |
| 12338 | AL | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Brown Drug Co, Inc. | Past | Accepting new patients | |
| Brown Drug Co Inc | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 109598 | AL | Yes |
| Pharmacist | 183500000X | 12338 | AL |
Addresses
Primary practice location
9081 Hwy 22
Maplesville, AL 36750-0141
Mailing address
PO Box 141
9081 Hwy 22
Maplesville, AL 36750-0141
Phone (334) 366-2425
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0124711 | Other | AL | NCPDP |
Other providers in Maplesville, AL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 8, 2007. 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.