Provider Demographics
NPI:1508303595
Name:CHANDLER, PATRICIA S (RPH)
Entity Type:Individual
Prefix:
First Name:PATRICIA
Middle Name:S
Last Name:CHANDLER
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 1:9161 HGHWY 29 SOUTH
Mailing Address - Street 2:
Mailing Address - City:HULL
Mailing Address - State:GA
Mailing Address - Zip Code:30646
Mailing Address - Country:US
Mailing Address - Phone:706-613-1734
Mailing Address - Fax:706-613-1909
Practice Address - Street 1:9161 HGHWY 29 SOUTH
Practice Address - Street 2:
Practice Address - City:HULL
Practice Address - State:GA
Practice Address - Zip Code:30646
Practice Address - Country:US
Practice Address - Phone:706-613-1734
Practice Address - Fax:706-613-1909
Is Sole Proprietor?:No
Enumeration Date:2017-01-27
Last Update Date:2017-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA015918183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist