Healthcare Provider Details

I. General information

NPI: 1619886827
Provider Name (Legal Business Name): PATRICE JAMISON PHARMD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/03/2026
Last Update Date: 09/03/2026
Certification Date: 09/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3330 CHASTAIN MEADOWS PKWY NW # 100
KENNESAW GA
30144-5881
US

IV. Provider business mailing address

1528 GREAT SHOALS CIR
LAWRENCEVILLE GA
30045-7093
US

V. Phone/Fax

Practice location:
  • Phone: 770-421-1399
  • Fax:
Mailing address:
  • Phone: 770-891-3104
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberRPH036502
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: