Provider Demographics
NPI:1811281199
Name:FOREMAN, LEE DEWAYNE (PHARMD)
Entity type:Individual
Prefix:DR
First Name:LEE
Middle Name:DEWAYNE
Last Name:FOREMAN
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 1:2640 ENTERPRISE DR
Mailing Address - Street 2:T-1499
Mailing Address - City:OPELIKA
Mailing Address - State:AL
Mailing Address - Zip Code:36801-1511
Mailing Address - Country:US
Mailing Address - Phone:334-745-4304
Mailing Address - Fax:334-745-4304
Practice Address - Street 1:2640 ENTERPRISE DR
Practice Address - Street 2:T-1499
Practice Address - City:OPELIKA
Practice Address - State:AL
Practice Address - Zip Code:36801-1511
Practice Address - Country:US
Practice Address - Phone:334-745-4304
Practice Address - Fax:334-745-4304
Is Sole Proprietor?:Yes
Enumeration Date:2011-06-04
Last Update Date:2011-06-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL15933183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist