Provider Demographics
NPI:1669354585
Name:CUNNINGHAM, JONATHAN DALE (PHARMD)
Entity type:Individual
Prefix:
First Name:JONATHAN
Middle Name:DALE
Last Name:CUNNINGHAM
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 1:2727 BRIARBERRY CIR APT A
Mailing Address - Street 2:
Mailing Address - City:VESTAVIA
Mailing Address - State:AL
Mailing Address - Zip Code:35226-3813
Mailing Address - Country:US
Mailing Address - Phone:205-777-1538
Mailing Address - Fax:
Practice Address - Street 1:3014 ALLISON BONNETT MEMORIAL DR STE 130
Practice Address - Street 2:
Practice Address - City:HUEYTOWN
Practice Address - State:AL
Practice Address - Zip Code:35023-2395
Practice Address - Country:US
Practice Address - Phone:205-497-5372
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-07-22
Last Update Date:2025-07-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL24189183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist