Provider Demographics
NPI:1902329303
Name:WEATHERFORD, WILLIAM E (RPH)
Entity Type:Individual
Prefix:MR
First Name:WILLIAM
Middle Name:E
Last Name:WEATHERFORD
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1082
Mailing Address - Street 2:
Mailing Address - City:RED BAY
Mailing Address - State:AL
Mailing Address - Zip Code:35582-1082
Mailing Address - Country:US
Mailing Address - Phone:256-356-4044
Mailing Address - Fax:256-356-4045
Practice Address - Street 1:925 4TH ST NW
Practice Address - Street 2:
Practice Address - City:RED BAY
Practice Address - State:AL
Practice Address - Zip Code:35582-3953
Practice Address - Country:US
Practice Address - Phone:256-356-4044
Practice Address - Fax:256-356-4045
Is Sole Proprietor?:Yes
Enumeration Date:2017-07-18
Last Update Date:2017-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL1147353336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy