Individual provider Active NPI

Elisabeth Erin Willis, PHARM.D.

  • Pharmacist
  • Moulton, AL
National Provider Identifier
1942593686
Registry record updated May 26, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
15786 Issued in AL
Practice address
11809 Al Highway 157
Moulton, AL 35650-2707
Phone
(256) 974-7663
Fax
(256) 905-0320
NPI assigned
May 26, 2011
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 26, 2011

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 15786 AL Primary

Addresses

Primary practice location

11809 Al Highway 157
Moulton, AL 35650-2707

Mailing address

11809 Al Highway 157
Moulton, AL 35650-2707
Phone (256) 974-7663

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

LicenseStateTypeSpecialty
15786ALMDFamily Medicine Physician

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1306368000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1306368000000",
    "number": "1942593686",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11809 AL HIGHWAY 157",
            "city": "MOULTON",
            "state": "AL",
            "postal_code": "356502707",
            "telephone_number": "256-974-7663",
            "fax_number": "256-905-0320"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11809 AL HIGHWAY 157",
            "city": "MOULTON",
            "state": "AL",
            "postal_code": "356502707",
            "telephone_number": "256-974-7663",
            "fax_number": "256-905-0320"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILLIS",
        "first_name": "ELISABETH",
        "middle_name": "ERIN",
        "credential": "PHARM.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-05-26",
        "last_updated": "2011-05-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "AL",
            "license": "15786",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Moulton, AL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 26, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.