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General NPI Number Information
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NPI Number | 1558435784
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Entity Type | Organization
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Legal Business Name | UNIVERSITY HEALTH CENTER, UNIVERSITY OF GA HEALTH CENTER PHARMACY
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Dates
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Enumeration Date | 11/20/2006
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Last Update Date | 02/24/2020
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Provider Practice Location Address
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Address Line | 55 CARLTON ST
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City | ATHENS
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State | GA
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Zip | 30602-1755
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Country | US
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Telephone | 706-542-9979
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Fax | 706-583-0276
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Provider Business Mailing Address
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Address Line | 55 CARLTON ST
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City | ATHENS
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State | GA
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Zip | 30602-1755
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Country | US
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Telephone | 706-542-9979
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Fax | 706-583-0276
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Authorized Official
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Title or Position | PHARMACY MANAGER
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Name | DR. BRADFORD UPCHURCH
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Credential | PHARM.D.
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Telephone | 706-542-9979
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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 |
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License Number State |
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