Provider Demographics
NPI:1447476841
Name:EPP, C LIONEL (BSPHARM)
Entity type:Individual
Prefix:MR
First Name:C
Middle Name:LIONEL
Last Name:EPP
Suffix:
Gender:M
Credentials:BSPHARM
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 553
Mailing Address - Street 2:
Mailing Address - City:ORANGE BEACH
Mailing Address - State:AL
Mailing Address - Zip Code:36561-0553
Mailing Address - Country:US
Mailing Address - Phone:251-981-4376
Mailing Address - Fax:
Practice Address - Street 1:25299 CANAL RD # A
Practice Address - Street 2:
Practice Address - City:ORANGE BEACH
Practice Address - State:AL
Practice Address - Zip Code:36561-5814
Practice Address - Country:US
Practice Address - Phone:251-981-4376
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL6038183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist