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MRS. ADELE DIANE DENNARD RPH

>> Pharmacist >> Pharmacy Service Providers

Registrant NPI Number: 1215078969

Individual Registrant:
MRS. ADELE DIANE DENNARD RPH
Gender: F
Not Sole Proprietor

Location and contact information for practice:
119 2ND ST N  SOPERTON, GA 30457-1177 US
Tel: 912-529-4545  Fax: 912-529-6161

Contact information for business:
1009 FLORIDA AVE  SOPERTON, GA 30457-1722 US
Tel: 912-529-5252  Fax: 912-529-6161

Registration Information:
NPI: 1215078969
Entity Type: Individual

Specialty information:

PrimaryCodeCategory/DescriptionStateLicense Number
Y183500000XPharmacy Service Providers
Pharmacist
GARPH016463

Legacy codes, insurance codes and state license numbers:

IssuerNumberStateType




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