Keith Bardes, RPH
Individual provider Active NPI Pharmacist · Flowery Branch, GA
NPI 1033239751 · NPPES record last updated Jul 8, 2007
Key facts
- NPI
- 1033239751
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Pharmacist 183500000X
- License
- 013310 (GA)
- Practice address
- 6370 Flat Rock Dr
Flowery Branch, GA 30542-5052 - Phone
- (770) 967-2965
- NPI assigned
- Mar 29, 2007
- Sex
- Male
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
- Credentials
- Registered Pharmacist
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 013310 | GA | Yes |
Addresses
Primary practice location
6370 Flat Rock Dr
Flowery Branch, GA 30542-5052
Mailing address
3300 Hamilton Mill Rd
Buford, GA 30519-4080
Phone (770) 904-7188
Other providers in Flowery Branch, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 8, 2007. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.