Provider Demographics
NPI:1588267041
Name:RUSH, KIMBERLY SAYLORS (RPH)
Entity type:Individual
Prefix:MRS
First Name:KIMBERLY
Middle Name:SAYLORS
Last Name:RUSH
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:MISS
Other - First Name:KIMBERLY
Other - Middle Name:SUE
Other - Last Name:SAYLORS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RPH
Mailing Address - Street 1:247 US HIGHWAY 11
Mailing Address - Street 2:
Mailing Address - City:TRUSSVILLE
Mailing Address - State:AL
Mailing Address - Zip Code:35173-4258
Mailing Address - Country:US
Mailing Address - Phone:205-467-2223
Mailing Address - Fax:205-467-0253
Practice Address - Street 1:247 US HIGHWAY 11
Practice Address - Street 2:
Practice Address - City:TRUSSVILLE
Practice Address - State:AL
Practice Address - Zip Code:35173-4258
Practice Address - Country:US
Practice Address - Phone:205-467-2223
Practice Address - Fax:205-467-0253
Is Sole Proprietor?:No
Enumeration Date:2020-11-18
Last Update Date:2020-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL11399183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist