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KENYARDA DURDEN PHARMD

>> Pharmacist >> Pharmacy Service Providers

Registrant NPI Number: 1730645375

Individual Registrant:
 KENYARDA  DURDEN PHARMD
Gender: F
Not Sole Proprietor

Location and contact information for practice:
1060 LAKES BLVD  LAKE PARK, GA 31636-3013 US
Tel: 229-559-7736  Fax: --

Contact information for business:
1060 LAKES BLVD  LAKE PARK, GA 31636-3013 US
Tel: 229-559-7736  Fax: --

Registration Information:
NPI: 1730645375
Entity Type: Individual

Specialty information:

PrimaryCodeCategory/DescriptionStateLicense Number
Y183500000XPharmacy Service Providers
Pharmacist
GARPH-031111

Legacy codes, insurance codes and state license numbers:

IssuerNumberStateType




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