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General NPI Number Information
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NPI Number | 1477101640
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Entity Type | Individual
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Provider Name | CARLA E GILLESPIE PHARM.D
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Gender | Female
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Dates
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Enumeration Date | 08/29/2019
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Last Update Date | 08/29/2019
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Provider Practice Location Address
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Address Line | 1030 DELTA BLVD
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City | ATLANTA
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State | GA
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Zip | 30354-1989
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Country | US
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Telephone | 404-305-8890
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Fax |
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Provider Business Mailing Address
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Address Line | 145 WESTCHESTER DR SE
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City | SMYRNA
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State | GA
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Zip | 30082-5050
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Country | US
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Telephone | 770-431-9657
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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 | 183500000X
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Taxonomy Name | Pharmacist
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License Number | RPH016094
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License Number State | GA
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