Healthcare Provider Details

I. General information

NPI: 1588725428
Provider Name (Legal Business Name): CLAUDE WARREN BATES RPH
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/13/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2295 OAK RD
SNELLVILLE GA
30078-2356
US

IV. Provider business mailing address

4095 MOUNT CARMEL CHURCH RD
MONROE GA
30655-5183
US

V. Phone/Fax

Practice location:
  • Phone: 770-972-0700
  • Fax: 770-972-0701
Mailing address:
  • Phone: 770-207-9036
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberRPH010142
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: