Provider Demographics
NPI:1366607632
Name:NEWSOME, AUDREY DAVIE (PHARMD)
Entity type:Individual
Prefix:DR
First Name:AUDREY
Middle Name:DAVIE
Last Name:NEWSOME
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 1:221 E SOUTH ST
Mailing Address - Street 2:
Mailing Address - City:DADEVILLE
Mailing Address - State:AL
Mailing Address - Zip Code:36853-1923
Mailing Address - Country:US
Mailing Address - Phone:256-825-0063
Mailing Address - Fax:256-825-0063
Practice Address - Street 1:221 E SOUTH ST
Practice Address - Street 2:
Practice Address - City:DADEVILLE
Practice Address - State:AL
Practice Address - Zip Code:36853-1923
Practice Address - Country:US
Practice Address - Phone:256-825-0063
Practice Address - Fax:256-825-5584
Is Sole Proprietor?:No
Enumeration Date:2008-07-25
Last Update Date:2021-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL15275183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist