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NPI Code Detail

MEDICARE: JACQUELINE HALLIE SIERS PHARM.D.

MEDICARE: JACQUELINE HALLIE SIERS PHARM.D.
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
1183500000XPharmacist025664GA
2183500000XPharmacist13070SC

General Provider Information

NPI Number : 1225313406
Entity Type Code : Individual
Provider Name (Legal Business Name) : JACQUELINE HALLIE SIERS PHARM.D.
Provider Business Mailing Address
First Line : 152 RIDLEY CIR
Second Line :
City : DECATUR
State : GA
Zip : 30030-1117
Country : US
Telephone Number : 843-478-4273
Fax Number :
Provider Business Practice Location Address
First Line : 2175 PARKLAKE DR NE
Second Line :
City : ATLANTA
State : GA
Zip : 30345-2845
Country : US
Telephone Number : 770-496-7400
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/19/2011
Last Update Date : 08/07/2013

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