Provider Demographics
NPI:1518567684
Name:MANNING, JULIA HART (RPH)
Entity Type:Individual
Prefix:
First Name:JULIA
Middle Name:HART
Last Name:MANNING
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 1:1155 BATTLEFIELD PKWY
Mailing Address - Street 2:
Mailing Address - City:FORT OGLETHORPE
Mailing Address - State:GA
Mailing Address - Zip Code:30742-3960
Mailing Address - Country:US
Mailing Address - Phone:762-887-6046
Mailing Address - Fax:762-887-6050
Practice Address - Street 1:1155 BATTLEFIELD PKWY
Practice Address - Street 2:
Practice Address - City:FORT OGLETHORPE
Practice Address - State:GA
Practice Address - Zip Code:30742-3960
Practice Address - Country:US
Practice Address - Phone:762-887-6046
Practice Address - Fax:762-887-6050
Is Sole Proprietor?:Yes
Enumeration Date:2020-10-28
Last Update Date:2020-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN0000010002183500000X
GARPH019413183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist