Provider Demographics
NPI:1326347352
Name:MARONIE, KRISTY HARDEN (PHARMACIST)
Entity Type:Individual
Prefix:
First Name:KRISTY
Middle Name:HARDEN
Last Name:MARONIE
Suffix:
Gender:F
Credentials:PHARMACIST
Other - Prefix:
Other - First Name:KRISTY
Other - Middle Name:ELIZABETH
Other - Last Name:HARDEN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PHARMACIST
Mailing Address - Street 1:1038 HWY 80 W
Mailing Address - Street 2:
Mailing Address - City:POOLER
Mailing Address - State:GA
Mailing Address - Zip Code:31322-2114
Mailing Address - Country:US
Mailing Address - Phone:912-748-5155
Mailing Address - Fax:912-748-3271
Practice Address - Street 1:1038 HWY 80 W
Practice Address - Street 2:
Practice Address - City:POOLER
Practice Address - State:GA
Practice Address - Zip Code:31322-2114
Practice Address - Country:US
Practice Address - Phone:912-748-5155
Practice Address - Fax:912-748-3271
Is Sole Proprietor?:No
Enumeration Date:2011-03-16
Last Update Date:2011-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARPH023960183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist