Provider Demographics
NPI:1366873580
Name:HERMANN, KARL (PHARMD)
Entity type:Individual
Prefix:DR
First Name:KARL
Middle Name:
Last Name:HERMANN
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2004 FLAGSTONE DR
Mailing Address - Street 2:APT 504
Mailing Address - City:MADISON
Mailing Address - State:AL
Mailing Address - Zip Code:35758-2954
Mailing Address - Country:US
Mailing Address - Phone:724-614-8584
Mailing Address - Fax:
Practice Address - Street 1:3500 MASTIN LAKE RD NW
Practice Address - Street 2:
Practice Address - City:HUNTSVILLE
Practice Address - State:AL
Practice Address - Zip Code:35810-2624
Practice Address - Country:US
Practice Address - Phone:256-851-4188
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-12-13
Last Update Date:2013-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL17539183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist