MEDICARE: DR. MEGAN REBEKAH FREEMAN PHARMD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	183500000X	Pharmacist	020860	GA
2	1835P1200X	Pharmacotherapy Pharmacist	020860	GA

General Provider Information

NPI Number	:	1184624587
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MEGAN REBEKAH FREEMAN PHARMD

Provider Business Mailing Address
First Line	:	160 SPALDING CREEK CT
Second Line	:
City	:	ATLANTA
State	:	GA
Zip	:	30350-1176
Country	:	US
Telephone Number	:	404-459-1093
Fax Number	:	404-851-8610

Provider Business Practice Location Address
First Line	:	1000 JOHNSON FERRY RD NE
Second Line	:	NORTHSIDE HOSPITAL DEPARTMENT OF PHARMACY
City	:	ATLANTA
State	:	GA
Zip	:	30342-1606
Country	:	US
Telephone Number	:	404-459-1093
Fax Number	:	404-851-8610

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/28/2005
Last Update Date	:	08/01/2011

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