Provider Demographics
NPI:1215228358
Name:COLLIER, JAIME MICHELE (PHARMD)
Entity Type:Individual
Prefix:
First Name:JAIME
Middle Name:MICHELE
Last Name:COLLIER
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3330 HAMILTON MILL RD
Mailing Address - Street 2:
Mailing Address - City:BUFORD
Mailing Address - State:GA
Mailing Address - Zip Code:30519-4005
Mailing Address - Country:US
Mailing Address - Phone:770-904-7188
Mailing Address - Fax:770-904-7193
Practice Address - Street 1:3330 HAMILTON MILL RD
Practice Address - Street 2:
Practice Address - City:BUFORD
Practice Address - State:GA
Practice Address - Zip Code:30519-4005
Practice Address - Country:US
Practice Address - Phone:770-904-7188
Practice Address - Fax:770-904-7193
Is Sole Proprietor?:No
Enumeration Date:2011-04-24
Last Update Date:2011-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARPH022186183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist