Healthcare Provider Details

I. General information

NPI: 1982511457
Provider Name (Legal Business Name): CRYSTAL ABIGAIL RODRIGUEZ RPH036477
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/27/2026
Last Update Date: 09/07/2026
Certification Date: 09/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3446 WINDER HWY
FLOWERY BRANCH GA
30542-3007
US

IV. Provider business mailing address

3446 WINDER HWY
FLOWERY BRANCH GA
30542-3007
US

V. Phone/Fax

Practice location:
  • Phone: 770-538-4276
  • Fax:
Mailing address:
  • Phone: 770-538-4276
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberRPH036477
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: