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NPI Code Detail

MEDICARE: MR. JOHN GUY GREEN III RPH

MEDICARE: MR. JOHN GUY GREEN III RPH
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
1183500000XPharmacist013183GA

General Provider Information

NPI Number : 1437393956
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. JOHN GUY GREEN III RPH
Provider Business Mailing Address
First Line : 3640 MUNDY MILL RD
Second Line :
City : GAINESVILLE
State : GA
Zip : 30504-4152
Country : US
Telephone Number : 770-532-9111
Fax Number : 770-536-7858
Provider Business Practice Location Address
First Line : 3640 MUNDY MILL RD
Second Line :
City : GAINESVILLE
State : GA
Zip : 30504-4152
Country : US
Telephone Number : 770-532-9111
Fax Number : 770-536-7858
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/28/2009
Last Update Date : 04/28/2009

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