Provider Demographics
NPI:1992407761
Name:ALVERSON, HELEN
Entity type:Individual
Prefix:
First Name:HELEN
Middle Name:
Last Name:ALVERSON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:301 E THREE NOTCH ST
Mailing Address - Street 2:
Mailing Address - City:ANDALUSIA
Mailing Address - State:AL
Mailing Address - Zip Code:36420-3124
Mailing Address - Country:US
Mailing Address - Phone:334-222-8825
Mailing Address - Fax:334-222-2761
Practice Address - Street 1:301 E THREE NOTCH ST
Practice Address - Street 2:
Practice Address - City:ANDALUSIA
Practice Address - State:AL
Practice Address - Zip Code:36420-3124
Practice Address - Country:US
Practice Address - Phone:334-222-8825
Practice Address - Fax:334-222-2761
Is Sole Proprietor?:Yes
Enumeration Date:2023-03-17
Last Update Date:2023-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL17433183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist