MEDICARE: DR. JEAN-MAURICE GUILBAUD 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
1	183500000X	Pharmacist	RPH019676	GA

General Provider Information

NPI Number	:	1750383501
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JEAN-MAURICE GUILBAUD PHARM.D.

Provider Business Mailing Address
First Line	:	1003 COLONNADE WAY
Second Line	:
City	:	MILTON
State	:	GA
Zip	:	30004-8248
Country	:	US
Telephone Number	:	404-936-1677
Fax Number	:

Provider Business Practice Location Address
First Line	:	1003 COLONNADE WAY
Second Line	:
City	:	MILTON
State	:	GA
Zip	:	30004-8248
Country	:	US
Telephone Number	:	404-936-1677
Fax Number	:	404-851-8610

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

Provider Enumeration Date	:	08/11/2005
Last Update Date	:	01/02/2014

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