Healthcare Provider Details

I. General information

NPI: 1184624587
Provider Name (Legal Business Name): MEGAN REBEKAH FREEMAN PHARMD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/28/2005
Last Update Date: 08/01/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1000 JOHNSON FERRY RD NE NORTHSIDE HOSPITAL DEPARTMENT OF PHARMACY
ATLANTA GA
30342-1606
US

IV. Provider business mailing address

160 SPALDING CREEK CT
ATLANTA GA
30350-1176
US

V. Phone/Fax

Practice location:
  • Phone: 404-459-1093
  • Fax: 404-851-8610
Mailing address:
  • Phone: 404-459-1093
  • Fax: 404-851-8610

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number020860
License Number StateGA
# 2
Primary TaxonomyN
Taxonomy Code1835P1200X
TaxonomyPharmacotherapy Pharmacist
License Number020860
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: