Provider Demographics
NPI:1699334243
Name:BALL, CHARLES ALDEN (PHARMD)
Entity type:Individual
Prefix:DR
First Name:CHARLES
Middle Name:ALDEN
Last Name:BALL
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 1:2304 2ND AVE NE
Mailing Address - Street 2:
Mailing Address - City:TUSCALOOSA
Mailing Address - State:AL
Mailing Address - Zip Code:35406-1914
Mailing Address - Country:US
Mailing Address - Phone:205-233-1174
Mailing Address - Fax:
Practice Address - Street 1:2304 2ND AVE NE
Practice Address - Street 2:
Practice Address - City:TUSCALOOSA
Practice Address - State:AL
Practice Address - Zip Code:35406-1914
Practice Address - Country:US
Practice Address - Phone:205-233-1174
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-06-07
Last Update Date:2019-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL126491835X0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835X0200XPharmacy Service ProvidersPharmacistOncology