Provider Demographics
NPI:1366555013
Name:TAMMY V GARRETT
Entity type:Organization
Organization Name:TAMMY V GARRETT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PIC
Authorized Official - Prefix:
Authorized Official - First Name:TAMMY
Authorized Official - Middle Name:V
Authorized Official - Last Name:GARRETT
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:256-232-6588
Mailing Address - Street 1:11234 DRENNEN DR
Mailing Address - Street 2:
Mailing Address - City:TANNER
Mailing Address - State:AL
Mailing Address - Zip Code:35671-3622
Mailing Address - Country:US
Mailing Address - Phone:256-232-6588
Mailing Address - Fax:256-232-6589
Practice Address - Street 1:11964 ESCUE DR STE A
Practice Address - Street 2:
Practice Address - City:TANNER
Practice Address - State:AL
Practice Address - Zip Code:35671-3680
Practice Address - Country:US
Practice Address - Phone:256-232-6588
Practice Address - Fax:256-232-6589
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-16
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL111155183500000X
AL11095183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes183500000XPharmacy Service ProvidersPharmacistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL0127755OtherNCPDP
AL51099925OtherBCBS DME
AL009985880Medicaid
AL100002934Medicaid
AL51099925OtherBCBS DME