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General NPI Number Information
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NPI Number | 1932227220
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Entity Type | Individual
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Provider Name | CHARLES NOLAN DOOLEY SR. R.PH.
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Gender | Male
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Dates
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Enumeration Date | 03/26/2007
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Last Update Date | 06/05/2013
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Provider Practice Location Address
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Address Line | 101 RIVERSTONE VIS SUITE 100
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City | BLUE RIDGE
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State | GA
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Zip | 30513-6648
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Country | US
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Telephone | 706-258-2294
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Fax |
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Provider Business Mailing Address
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Address Line | 51 WEAVER DR
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City | JEFFERSON
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State | GA
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Zip | 30549-6754
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Country | US
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Telephone | 678-963-8080
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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 | RPH017482
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License Number State | GA
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