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NPI Code Detail

MEDICARE: DR. BROOKE CELESTE OGDEN

MEDICARE: DR. BROOKE CELESTE OGDEN
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
1183500000XPharmacistRPH030139GA

General Provider Information

NPI Number : 1528585957
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. BROOKE CELESTE OGDEN
Provider Business Mailing Address
First Line : 1130 OLD BUIE RD
Second Line :
City : ODUM
State : GA
Zip : 31555-9211
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 3487 CYPRESS MILL RD
Second Line :
City : BRUNSWICK
State : GA
Zip : 31520-2857
Country : US
Telephone Number : 912-265-6330
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/25/2017
Last Update Date : 08/25/2017

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Directions to “ DR. BROOKE CELESTE OGDEN ” Practice Location

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