Provider Demographics
NPI:1538249867
Name:DEAN, RUTH ANN (RPH)
Entity type:Individual
Prefix:
First Name:RUTH
Middle Name:ANN
Last Name:DEAN
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1320 REVERE CT
Mailing Address - Street 2:
Mailing Address - City:MOBILE
Mailing Address - State:AL
Mailing Address - Zip Code:36695-3556
Mailing Address - Country:US
Mailing Address - Phone:251-633-4177
Mailing Address - Fax:
Practice Address - Street 1:9082 MOFFETT RD
Practice Address - Street 2:WINN-DIXIE PHARMACY
Practice Address - City:SEMMES
Practice Address - State:AL
Practice Address - Zip Code:36575-5242
Practice Address - Country:US
Practice Address - Phone:251-649-0663
Practice Address - Fax:251-649-6698
Is Sole Proprietor?:No
Enumeration Date:2006-10-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL7585183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist