Healthcare Provider Details

I. General information

NPI: 1437456365
Provider Name (Legal Business Name): CHRISTINE MCFAYDEN KLEIN PHARM.D
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/11/2011
Last Update Date: 02/09/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3001 MERCER UNIVERSITY DR DEPT OF PHARMACY PRACTICE
ATLANTA GA
30341-4115
US

IV. Provider business mailing address

3001 MERCER UNIVERSITY DR DEPT. OF PHARMACY PRACTICE
ATLANTA GA
30341-4115
US

V. Phone/Fax

Practice location:
  • Phone: 678-547-6294
  • Fax:
Mailing address:
  • Phone: 678-547-6294
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1835G0303X
TaxonomyGeriatric Pharmacist
License Number17401
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: