Provider Demographics
NPI:1194047456
Name:WASHER, MARYALYS W (RPH)
Entity type:Individual
Prefix:MRS
First Name:MARYALYS
Middle Name:W
Last Name:WASHER
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 1:604 S SANDERS RD
Mailing Address - Street 2:
Mailing Address - City:HOOVER
Mailing Address - State:AL
Mailing Address - Zip Code:35226-2444
Mailing Address - Country:US
Mailing Address - Phone:205-478-5288
Mailing Address - Fax:
Practice Address - Street 1:230 GREEN SPRINGS HWY
Practice Address - Street 2:
Practice Address - City:HOMEWOOD
Practice Address - State:AL
Practice Address - Zip Code:35209-4906
Practice Address - Country:US
Practice Address - Phone:205-916-0710
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-02-26
Last Update Date:2010-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL11484183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist