Active NPI
Chiangchanh Phothisane, PHARMD
- Pharmacist
- Montgomery, AL
National Provider Identifier
1760856652
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 14442
- Practice address
- 1080 Eastern Blvd
Montgomery, AL 36117-1919 - Phone
- (334) 277-5454
- Fax
- (334) 277-6252
- NPI assigned
- Nov 16, 2015
- Last updated
- Nov 16, 2015
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 14442 | AL | Primary |
Addresses
Primary practice location
1080 Eastern Blvd
Montgomery, AL 36117-1919
Mailing address
93 Mountain Terrace LN
Wetumpka, AL 36093-3920
Phone (334) 514-7808
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 14442 | Other | AL | STATE LICENSE |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Pharmacy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 14442 | AL | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1447632000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1447632000000",
"number": "1760856652",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "93 MOUNTAIN TERRACE LN",
"city": "WETUMPKA",
"state": "AL",
"postal_code": "360933920",
"telephone_number": "334-514-7808"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1080 EASTERN BLVD",
"city": "MONTGOMERY",
"state": "AL",
"postal_code": "361171919",
"telephone_number": "334-277-5454",
"fax_number": "334-277-6252"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PHOTHISANE",
"first_name": "CHIANGCHANH",
"name_prefix": "Dr.",
"credential": "PHARMD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2015-11-16",
"last_updated": "2015-11-16",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "AL",
"license": "14442",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "STATE LICENSE",
"identifier": "14442",
"state": "AL"
}
],
"endpoints": [],
"other_names": []
}Other providers in Montgomery, AL
- Savannah Phillips, LHAS
- Tiffany Phillips
- William Phillips, PHARM.D.
- Justin Wesley Phillpott, M.D.
- Chethana R. Phonde, M.D.
- Chris H Phung, RPH
- Physicians Choice Dialysis of Alabama LLC (Physicians Choice Dialysis - Montgomery)
- Physicians Choice Dialysis of Alabama LLC (Physicians Choice Dialysis - East Montgomery)
- Physicians Choice Dialysis of Montgomery LLC
- Physicians for Women
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 16, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.