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General NPI Number Information
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NPI Number | 1699073676
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Entity Type | Individual
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Provider Name | CAROLYN TYLER GRIFFIN
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Gender | Female
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Dates
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Enumeration Date | 03/01/2011
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Last Update Date | 03/01/2011
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Provider Practice Location Address
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Address Line | 211 TEMPLE AVE
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City | NEWNAN
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State | GA
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Zip | 30263-1328
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Country | US
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Telephone | 770-253-8562
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Fax | 770-304-3701
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Provider Business Mailing Address
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Address Line | 15 PINE NEEDLE CT
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City | NEWNAN
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State | GA
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Zip | 30263-4160
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Country | US
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Telephone | 770-253-2927
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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 | 016576
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License Number State | GA
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