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DR. MARLA MARIE MITCHAM PHARMD

>> Pharmacist >> Pharmacy Service Providers

Registrant NPI Number: 1043822067

Individual Registrant:
DR. MARLA MARIE MITCHAM PHARMD
Gender: F
Not Sole Proprietor

Location and contact information for practice:
100 MYRTLE BLVD. PHARMACY BLDG. 15 ROOM G12 GRACEWOOD, GA 30812 US
Tel: 706-790-2496  Fax: 706-790-2340

Contact information for business:
100 MYRTLE BLVD. PHARMACY BLDG. 15 ROOM G12 GRACEWOOD, GA 30812 US
Tel: 706-790-2496  Fax: 706-790-2340

Registration Information:
NPI: 1043822067
Entity Type: Individual

Specialty information:

PrimaryCodeCategory/DescriptionStateLicense Number
Y183500000XPharmacy Service Providers
Pharmacist
GARPH029883

Legacy codes, insurance codes and state license numbers:

IssuerNumberStateType
PHARMACIST LICENSERPH029883GA01




HEALTH CARE JOBS GA - Page 1



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