Samuel Joseph Freeman

Individual provider Active NPI Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist · Toccoa, GA

NPI 1134895634 · NPPES record last updated Aug 17, 2021

Key facts

NPI
1134895634
Entity type
Individual (NPI type 1)
Primary specialty
Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist 1835P0018X
License
030947 (GA)
Practice address
1330 Big a Rd
Toccoa, GA 30577-6013
Phone
(706) 886-3119
NPI assigned
Aug 17, 2021
Sex
Male
Sole proprietor
No

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
030947GAMDObstetrics & Gynecology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
JSB Health, LLC Past
since Aug 28, 2021
Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist 1835P0018X 030947 GA Yes

Addresses

Primary practice location

1330 Big a Rd
Toccoa, GA 30577-6013

Mailing address

1330 Big a Rd
Toccoa, GA 30577-6013
Phone (706) 886-3119

Other providers in Toccoa, GA

All providers in Toccoa, GA · Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist in Georgia

Sources for this page

Verify at the official NPI Registry.