Provider Demographics
NPI:1043479314
Name:MORRIS, KENWIN CH (PHARMD)
Entity Type:Individual
Prefix:
First Name:KENWIN
Middle Name:CH
Last Name:MORRIS
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:400 REXHAM WAY SW
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30331-7994
Mailing Address - Country:US
Mailing Address - Phone:404-344-5326
Mailing Address - Fax:404-344-5326
Practice Address - Street 1:400 REXHAM WAY SW
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30331-7994
Practice Address - Country:US
Practice Address - Phone:404-344-5326
Practice Address - Fax:404-344-5326
Is Sole Proprietor?:Yes
Enumeration Date:2008-06-03
Last Update Date:2008-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARPH0224631835P1200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P1200XPharmacy Service ProvidersPharmacistPharmacotherapy