Jennifer Gaddie, PHARM.D.
Individual provider Active NPI Pharmacist · Bowdon, GA
NPI 1114330107 · NPPES record last updated Jun 6, 2014
Key facts
- NPI
- 1114330107
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Pharmacist 183500000X
- License
- RPH027251 (GA)
- Practice address
- 128 Lovvorn Ave
Bowdon, GA 30108-1141 - Phone
- (770) 258-3310
- NPI assigned
- Jun 6, 2014
- Sex
- Female
- 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
- Doctor of Pharmacy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| RPH027251 | GA | MD | Pharmacist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | RPH027251 | GA | Yes |
Addresses
Primary practice location
128 Lovvorn Ave
Bowdon, GA 30108-1141
Mailing address
203 Brazell St
Hogansville, GA 30230-1109
Phone (678) 621-3068
Other providers in Bowdon, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 6, 2014. 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.