Healthcare Provider Details

I. General information

NPI: 1306322482
Provider Name (Legal Business Name): ASHLEY GROZIER PHARMD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/12/2018
Last Update Date: 07/12/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

104 TOWN BLVD NE # A100
BROOKHAVEN GA
30319-3146
US

IV. Provider business mailing address

604 LENOX WAY NE
ATLANTA GA
30324-2828
US

V. Phone/Fax

Practice location:
  • Phone: 404-233-7480
  • Fax: 404-233-7484
Mailing address:
  • Phone: 941-504-4995
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberRPH030675
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: