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General NPI Number Information
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NPI Number | 1467967208
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Entity Type | Individual
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Provider Name | REJEANNE RICHARD
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Gender | Female
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Dates
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Enumeration Date | 12/01/2017
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Last Update Date | 12/01/2017
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Provider Practice Location Address
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Address Line | 3495 PIEDMONT RD NE
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City | ATLANTA
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State | GA
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Zip | 30305-1717
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Country | US
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Telephone | 404-760-3511
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Fax |
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Provider Business Mailing Address
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Address Line | 1108 VENETIAN LN
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City | HAMPTON
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State | GA
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Zip | 30228-6047
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1835P0018X
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Taxonomy Name | Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
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License Number | 028115
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License Number State | GA
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