MEDICARE: DR. DENISE ROCHELLE CHARMAINE BREURE 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	RPH023829	GA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	RPH023829	OTHER	GA	STATE BORAD

General Provider Information

NPI Number	:	1932483039
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. DENISE ROCHELLE CHARMAINE BREURE PHARM.D.

Provider Business Mailing Address
First Line	:	4051 E SPRING MEADOW DR
Second Line	:
City	:	ACWORTH
State	:	GA
Zip	:	30101-7237
Country	:	US
Telephone Number	:	404-906-3343
Fax Number	:

Provider Business Practice Location Address
First Line	:	4051 E SPRING MEADOW DR
Second Line	:
City	:	ACWORTH
State	:	GA
Zip	:	30101-7237
Country	:	US
Telephone Number	:	404-906-3343
Fax Number	:

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

Provider Enumeration Date	:	10/06/2011
Last Update Date	:	10/06/2011

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