Provider Demographics
NPI:1225633282
Name:FFRENCH-CROSS, CARLEEN (PHARMD)
Entity Type:Individual
Prefix:
First Name:CARLEEN
Middle Name:
Last Name:FFRENCH-CROSS
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 1:4317 CHAMBLEE TUCKER RD
Mailing Address - Street 2:
Mailing Address - City:TUCKER
Mailing Address - State:GA
Mailing Address - Zip Code:30084-2106
Mailing Address - Country:US
Mailing Address - Phone:770-938-6146
Mailing Address - Fax:
Practice Address - Street 1:4317 CHAMBLEE TUCKER RD
Practice Address - Street 2:
Practice Address - City:TUCKER
Practice Address - State:GA
Practice Address - Zip Code:30084-2106
Practice Address - Country:US
Practice Address - Phone:770-938-6146
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-11-30
Last Update Date:2020-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA027569183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist