Provider Demographics
NPI:1396845293
Name:GRADY, PEGGY (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:PEGGY
Middle Name:
Last Name:GRADY
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 1:4 EASTVIEW LN
Mailing Address - Street 2:
Mailing Address - City:SAVANNAH
Mailing Address - State:GA
Mailing Address - Zip Code:31410-2806
Mailing Address - Country:US
Mailing Address - Phone:912-786-7878
Mailing Address - Fax:912-786-7774
Practice Address - Street 1:4 EASTVIEW LN
Practice Address - Street 2:
Practice Address - City:SAVANNAH
Practice Address - State:GA
Practice Address - Zip Code:31410-2806
Practice Address - Country:US
Practice Address - Phone:912-786-7878
Practice Address - Fax:912-786-7774
Is Sole Proprietor?:No
Enumeration Date:2006-09-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARPH010160183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist