Provider Demographics
NPI:1508586744
Name:PHIPPS, AARON
Entity Type:Individual
Prefix:
First Name:AARON
Middle Name:
Last Name:PHIPPS
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:810 RUSWOOD RD
Mailing Address - Street 2:
Mailing Address - City:WINDER
Mailing Address - State:GA
Mailing Address - Zip Code:30680-2705
Mailing Address - Country:US
Mailing Address - Phone:678-963-8686
Mailing Address - Fax:
Practice Address - Street 1:199 HABERSHAM COUNTY SHOPPING CTR
Practice Address - Street 2:
Practice Address - City:CORNELIA
Practice Address - State:GA
Practice Address - Zip Code:30531-3412
Practice Address - Country:US
Practice Address - Phone:706-778-8099
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-08-29
Last Update Date:2022-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARPH033886183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist