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General NPI Number Information
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NPI Number | 1689088064
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Entity Type | Individual
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Provider Name | JIMMY GBEMI
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Gender | Male
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Dates
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Enumeration Date | 06/13/2014
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Last Update Date | 08/14/2025
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Provider Practice Location Address
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Address Line | 116 WINDWARD HLS
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City | MCDONOUGH
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State | GA
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Zip | 30253-5991
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Country | US
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Telephone | 478-278-8155
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Fax |
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Provider Business Mailing Address
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Address Line | 1776 PANOLA RD
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City | ELLENWOOD
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State | GA
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Zip | 30294-2856
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Country | US
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Telephone | 770-545-8555
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Fax | 770-545-8556
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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 | 023287
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License Number State | GA
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