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General NPI Number Information
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NPI Number | 1932646262
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Entity Type | Individual
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Provider Name | DAVID LEE DURHAM R.PH., D.PH.
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Gender | Male
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Dates
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Enumeration Date | 01/25/2017
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Last Update Date | 01/25/2017
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Provider Practice Location Address
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Address Line | 5679 APPALACHIAN HIGHWAY
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City | BLUE RIDGE
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State | GA
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Zip | 30513
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Country | US
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Telephone | 706-632-5026
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Fax | 706-632-3968
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Provider Business Mailing Address
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Address Line | 82 QUEEN'S LANE
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City | BLUE RIDGE
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State | GA
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Zip | 30513
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Country | US
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Telephone | 706-455-1846
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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 | RPH022769
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License Number State | GA
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Taxonomy #2
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 12002
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License Number State | TN
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Taxonomy #3
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 55769
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License Number State | FL
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Taxonomy #4
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 16320
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License Number State | NC
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