Provider Demographics
NPI:1992309173
Name:MONEYHAM, PATRICIA LINDSAY (PHARMD)
Entity type:Individual
Prefix:
First Name:PATRICIA
Middle Name:LINDSAY
Last Name:MONEYHAM
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:205 BROADWAY ST
Mailing Address - Street 2:
Mailing Address - City:BIRMINGHAM
Mailing Address - State:AL
Mailing Address - Zip Code:35209-5313
Mailing Address - Country:US
Mailing Address - Phone:843-345-1433
Mailing Address - Fax:
Practice Address - Street 1:1431 11TH AVE S
Practice Address - Street 2:
Practice Address - City:BIRMINGHAM
Practice Address - State:AL
Practice Address - Zip Code:35205-3402
Practice Address - Country:US
Practice Address - Phone:205-933-8374
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-11-28
Last Update Date:2020-11-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL16098183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist