Provider Demographics
NPI:1154602720
Name:TRAMMELL, RANDALL TAYLOR (PHARMD)
Entity type:Individual
Prefix:DR
First Name:RANDALL
Middle Name:TAYLOR
Last Name:TRAMMELL
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 1:5502 CRESTWOOD BLVD
Mailing Address - Street 2:SUITE A
Mailing Address - City:BIRMINGHAM
Mailing Address - State:AL
Mailing Address - Zip Code:35212-4131
Mailing Address - Country:US
Mailing Address - Phone:205-564-0429
Mailing Address - Fax:
Practice Address - Street 1:5502 CRESTWOOD BLVD
Practice Address - Street 2:SUITE A
Practice Address - City:BIRMINGHAM
Practice Address - State:AL
Practice Address - Zip Code:35212-4131
Practice Address - Country:US
Practice Address - Phone:205-564-0429
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-09-08
Last Update Date:2017-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL16874183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist