Healthcare Provider Details

I. General information

NPI: 1861929002
Provider Name (Legal Business Name): JODI BISHOP RPH
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/18/2017
Last Update Date: 05/09/2026
Certification Date: 05/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1524 GA HIGHWAY 16 W
GRIFFIN GA
30223-2046
US

IV. Provider business mailing address

1524 GA HIGHWAY 16 W
GRIFFIN GA
30223-2046
US

V. Phone/Fax

Practice location:
  • Phone: 770-229-7430
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1835P0018X
TaxonomyPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
License NumberRPH035447
License Number StateGA
# 2
Primary TaxonomyN
Taxonomy Code183500000X
TaxonomyPharmacist
License Number03223696
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: