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General NPI Number Information
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NPI Number | 1831790310
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Entity Type | Individual
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Provider Name | JAY PERDUE PHARM D
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Gender | Male
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Dates
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Enumeration Date | 11/03/2020
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Last Update Date | 11/03/2020
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Provider Practice Location Address
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Address Line | 14030 ABERCORN ST
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City | SAVANNAH
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State | GA
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Zip | 31419-1935
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Country | US
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Telephone | 912-344-9664
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Fax |
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Provider Business Mailing Address
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Address Line | 350 BRYAN FISHERMANS COOP RD
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City | RICHMOND HILL
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State | GA
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Zip | 31324-9205
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Country | US
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Telephone | 706-580-7055
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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 | RPH025493
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License Number State | GA
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