Active NPI
Rosa Pettway
- Pharmacist
- York, AL
National Provider Identifier
1851405211
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 15100
- Practice address
- 583 4TH Ave
York, AL 36925-2008 - Phone
- (205) 392-5201
- NPI assigned
- Aug 19, 2006
- Last updated
- Jul 8, 2007
- 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 | 15100 | AL | Primary |
Addresses
Primary practice location
583 4TH Ave
York, AL 36925-2008
Mailing address
RR 2 Box 66B
Camden, AL 36726-9213
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 15100 | AL | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1155945600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1851405211",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "RR 2 BOX 66B",
"city": "CAMDEN",
"state": "AL",
"postal_code": "367269213"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "583 4TH AVE",
"city": "YORK",
"state": "AL",
"postal_code": "369252008",
"telephone_number": "205-392-5201"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PETTWAY",
"first_name": "ROSA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-08-19",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "AL",
"license": "15100",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in York, AL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.