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NPI Code Detail

MEDICARE: MAEGAN BENNETT EDGY RPH

MEDICARE: MAEGAN BENNETT EDGY 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
11835P1200XPharmacotherapy PharmacistRPH033166GA

General Provider Information

NPI Number : 1972272409
Entity Type Code : Individual
Provider Name (Legal Business Name) : MAEGAN BENNETT EDGY RPH
Provider Business Mailing Address
First Line : 341 ORBIT ST
Second Line :
City : FORTSON
State : GA
Zip : 31808-5022
Country : US
Telephone Number : 478-221-0148
Fax Number :
Provider Business Practice Location Address
First Line : 4808 BUENA VISTA RD
Second Line :
City : COLUMBUS
State : GA
Zip : 31907-5014
Country : US
Telephone Number : 706-569-9439
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/08/2021
Last Update Date : 09/08/2021

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