Provider Demographics
NPI:1124846613
Name:WERTHEIM, ANNA RAY (RPH)
Entity type:Individual
Prefix:MRS
First Name:ANNA
Middle Name:RAY
Last Name:WERTHEIM
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:570 RESTORATION DR
Mailing Address - Street 2:
Mailing Address - City:HOOVER
Mailing Address - State:AL
Mailing Address - Zip Code:35226-4243
Mailing Address - Country:US
Mailing Address - Phone:205-907-7470
Mailing Address - Fax:
Practice Address - Street 1:570 RESTORATION DR
Practice Address - Street 2:
Practice Address - City:HOOVER
Practice Address - State:AL
Practice Address - Zip Code:35226-4243
Practice Address - Country:US
Practice Address - Phone:205-907-7470
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-10-02
Last Update Date:2024-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL12325183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist