Provider Demographics
NPI:1104234368
Name:SPELLEN, SIMONE (PHARM D)
Entity type:Individual
Prefix:DR
First Name:SIMONE
Middle Name:
Last Name:SPELLEN
Suffix:
Gender:F
Credentials:PHARM D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5346 STADIUM TRACE PKWY
Mailing Address - Street 2:
Mailing Address - City:HOOVER
Mailing Address - State:AL
Mailing Address - Zip Code:35244-4582
Mailing Address - Country:US
Mailing Address - Phone:205-682-8078
Mailing Address - Fax:
Practice Address - Street 1:5346 STADIUM TRACE PKWY
Practice Address - Street 2:
Practice Address - City:HOOVER
Practice Address - State:AL
Practice Address - Zip Code:35244-4582
Practice Address - Country:US
Practice Address - Phone:205-682-8078
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-07-31
Last Update Date:2014-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL17864183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist