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NPI Code Detail

MEDICARE: MRS. DEBRA B CLEVELAND RPH

MEDICARE: MRS. DEBRA B CLEVELAND RPH
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1183500000XPharmacist12540GA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1RPH012540OTHERGASTATE PHARMACIST LICENSE

General Provider Information

NPI Number : 1205919487
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. DEBRA B CLEVELAND RPH
Provider Business Mailing Address
First Line : PO BOX 543
Second Line :
City : HARTWELL
State : GA
Zip : 30643-0543
Country : US
Telephone Number : 706-376-6901
Fax Number : 706-376-8687
Provider Business Practice Location Address
First Line : 118 ATHENS ST
Second Line :
City : HARTWELL
State : GA
Zip : 30643-1851
Country : US
Telephone Number : 706-376-5801
Fax Number : 706-376-8687
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/23/2006
Last Update Date : 02/01/2010

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