Healthcare Provider Details

I. General information

NPI: 1639023450
Provider Name (Legal Business Name): ASHLEE CHAREN-SYMONE GREENE
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/26/2026
Last Update Date: 08/20/2026
Certification Date: 08/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

250 W GREEN ST
ATHENS GA
30602-5036
US

IV. Provider business mailing address

117 MUIRFIELD LN
BYRON GA
31008-3920
US

V. Phone/Fax

Practice location:
  • Phone: 706-542-1911
  • Fax:
Mailing address:
  • Phone: 478-397-5528
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberRPH036450
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: