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NPI Code Detail

MEDICARE: NADENE A ROBERTS PHARMD

MEDICARE: NADENE A ROBERTS PHARMD
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
1183500000XPharmacistRPH026530GA

General Provider Information

NPI Number : 1982941753
Entity Type Code : Individual
Provider Name (Legal Business Name) : NADENE A ROBERTS PHARMD
Provider Business Mailing Address
First Line : 930 NEW HOPE RD
Second Line :
City : LAWRENCEVILLE
State : GA
Zip : 30045-6407
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 930 NEW HOPE RD
Second Line :
City : LAWRENCEVILLE
State : GA
Zip : 30045-6407
Country : US
Telephone Number : 770-682-2433
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/13/2013
Last Update Date : 01/13/2013

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