Provider Demographics
NPI:1477183911
Name:BACHTLE, ALLISON JUNE (PHARMD)
Entity Type:Individual
Prefix:
First Name:ALLISON
Middle Name:JUNE
Last Name:BACHTLE
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 1:2158 HENDRICKS CHURCH RD
Mailing Address - Street 2:
Mailing Address - City:THOMASTON
Mailing Address - State:GA
Mailing Address - Zip Code:30286-2296
Mailing Address - Country:US
Mailing Address - Phone:813-618-0561
Mailing Address - Fax:
Practice Address - Street 1:4400 BROWNSVILLE RD
Practice Address - Street 2:
Practice Address - City:POWDER SPRINGS
Practice Address - State:GA
Practice Address - Zip Code:30127-3199
Practice Address - Country:US
Practice Address - Phone:770-222-4205
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-01-23
Last Update Date:2020-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARPH0317001835P0018X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P0018XPharmacy Service ProvidersPharmacistPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist