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NPI Code Detail

MEDICARE: DR. GLEN RALPH JOHNSON PHARMD

MEDICARE:  DR. GLEN RALPH JOHNSON  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
1183500000XPharmacistRPH009914GA
2183500000XPharmacistPS 12439FL

General Provider Information

NPI Number : 1427291608
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. GLEN RALPH JOHNSON PHARMD
Provider Business Mailing Address
First Line : 901 SANTA FE TRL
Second Line :
City : MACON
State : GA
Zip : 31220-3724
Country : US
Telephone Number : 478-737-9920
Fax Number :
Provider Business Practice Location Address
First Line : 901 SANTA FE TRL
Second Line :
City : MACON
State : GA
Zip : 31220-3724
Country : US
Telephone Number : 478-474-1240
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/17/2009
Last Update Date : 10/26/2016

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Directions to “ DR. GLEN RALPH JOHNSON PHARMD” Practice Location

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