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THERON GLENN FOX

>> Pharmacist >> Pharmacy Service Providers

Registrant NPI Number: 1841304383

Individual Registrant:
 THERON GLENN FOX 
Gender: M
Sole Proprietor

Location and contact information for practice:
204 BUTLER AVE  MIDWAY, GA 31320 US
Tel: 912-884-9255  Fax: --

Contact information for business:
699 STARR CREEK RD  RICHMOND HILL, GA 31324-6118 US
Tel: 912-727-2240  Fax: --

Registration Information:
NPI: 1841304383
Entity Type: Individual

Specialty information:

PrimaryCodeCategory/DescriptionStateLicense Number
Y183500000XPharmacy Service Providers
Pharmacist
GARPH010499

Legacy codes, insurance codes and state license numbers:

IssuerNumberStateType




HEALTH CARE JOBS GA - Page 1



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