Provider Demographics
NPI:1457847485
Name:GRIFFIN, TAMMY (RPH)
Entity Type:Individual
Prefix:
First Name:TAMMY
Middle Name:
Last Name:GRIFFIN
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:84 CLEVELAND HIGHWAY
Mailing Address - Street 2:
Mailing Address - City:CLEVELAND
Mailing Address - State:GA
Mailing Address - Zip Code:30528-7804
Mailing Address - Country:US
Mailing Address - Phone:706-219-2273
Mailing Address - Fax:
Practice Address - Street 1:84 CLEVELAND HIGHWAY
Practice Address - Street 2:
Practice Address - City:CLEVELAND
Practice Address - State:GA
Practice Address - Zip Code:30528-7804
Practice Address - Country:US
Practice Address - Phone:706-219-2273
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-07-02
Last Update Date:2018-07-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARPH020335183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist