Provider Demographics
NPI:1043842719
Name:DESGAIN, KATHRYN DUKE (RPH)
Entity Type:Individual
Prefix:
First Name:KATHRYN
Middle Name:DUKE
Last Name:DESGAIN
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1101 N PEACHTREE PKWY
Mailing Address - Street 2:
Mailing Address - City:PEACHTREE CITY
Mailing Address - State:GA
Mailing Address - Zip Code:30269-4209
Mailing Address - Country:US
Mailing Address - Phone:770-486-7211
Mailing Address - Fax:
Practice Address - Street 1:1101 N PEACHTREE PKWY
Practice Address - Street 2:
Practice Address - City:PEACHTREE CITY
Practice Address - State:GA
Practice Address - Zip Code:30269-4209
Practice Address - Country:US
Practice Address - Phone:770-486-7211
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-02-10
Last Update Date:2020-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARPH0183811835P0018X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P0018XPharmacy Service ProvidersPharmacistPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist