NPI age
11 years
Enumerated 2014-06-28
Across 8384 active pharmacist providers in Georgia.
| Type | Value | Notes |
|---|---|---|
| 01 (AL) | 17728 | STATE LICENSE |
| 01 (GA) | RPH029474 | STATE LICENSE |
Part of a multi-provider practice. 4 other active providers share this practice address in NPPES.
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