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General NPI Number Information
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NPI Number | 1528585957
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Entity Type | Individual
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Provider Name | DR. BROOKE CELESTE OGDEN
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Gender | Female
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Dates
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Enumeration Date | 08/25/2017
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Last Update Date | 08/25/2017
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Provider Practice Location Address
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Address Line | 3487 CYPRESS MILL RD
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City | BRUNSWICK
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State | GA
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Zip | 31520-2857
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Country | US
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Telephone | 912-265-6330
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Fax |
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Provider Business Mailing Address
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Address Line | 1130 OLD BUIE RD
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City | ODUM
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State | GA
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Zip | 31555-9211
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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 | 183500000X
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Taxonomy Name | Pharmacist
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License Number | RPH030139
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License Number State | GA
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