Healthcare Provider Details

I. General information

NPI: 1851053581
Provider Name (Legal Business Name): GINA MARIE RUGGERI PHARMD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/11/2021
Last Update Date: 10/11/2021
Certification Date: 10/11/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6050 SINGLETON RD
NORCROSS GA
30093-1923
US

IV. Provider business mailing address

2595 WATERFORD PARK DR
LAWRENCEVILLE GA
30044-2731
US

V. Phone/Fax

Practice location:
  • Phone: 770-242-3340
  • Fax:
Mailing address:
  • Phone: 678-600-5845
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberRPH033293
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: