Provider Demographics
NPI:1144612284
Name:MARTIN, BRITTNEY (PHARM D)
Entity Type:Individual
Prefix:MRS
First Name:BRITTNEY
Middle Name:
Last Name:MARTIN
Suffix:
Gender:F
Credentials:PHARM D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1605 SHURLING DR
Mailing Address - Street 2:
Mailing Address - City:MACON
Mailing Address - State:GA
Mailing Address - Zip Code:31211-2150
Mailing Address - Country:US
Mailing Address - Phone:478-745-0004
Mailing Address - Fax:478-746-0240
Practice Address - Street 1:1605 SHURLING DR
Practice Address - Street 2:
Practice Address - City:MACON
Practice Address - State:GA
Practice Address - Zip Code:31211-2150
Practice Address - Country:US
Practice Address - Phone:478-745-0004
Practice Address - Fax:478-746-0240
Is Sole Proprietor?:No
Enumeration Date:2015-02-26
Last Update Date:2015-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARPH023744183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
GARPH023744OtherSTATE LICENSE