Basic Information
| Provider Information | |||||||||
| NPI: | 1477555381 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | LANDER | ||||||||
| FirstName: | ROGER | ||||||||
| MiddleName: | DALE | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | PHARM.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 5330 HICKORY TRACE | ||||||||
| Address2: | |||||||||
| City: | HOOVER | ||||||||
| State: | AL | ||||||||
| PostalCode: | 352444543 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2057262399 | ||||||||
| FaxNumber: | 2057262669 | ||||||||
| Practice Location | |||||||||
| Address1: | 1400 6TH AVE S | ||||||||
| Address2: | |||||||||
| City: | BIRMINGHAM | ||||||||
| State: | AL | ||||||||
| PostalCode: | 352331502 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2057262399 | ||||||||
| FaxNumber: | 2057262669 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 08/10/2005 | ||||||||
| LastUpdateDate: | 07/08/2007 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | X | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 1835P1200X | 11044 | AL | Y | Pharmacy Service Providers | Pharmacist | Pharmacotherapy |
No ID Information.