Provider Demographics
NPI:1568457364
Name:AUGELLO, FREDERICK J JR (RPH)
Entity Type:Individual
Prefix:MR
First Name:FREDERICK
Middle Name:J
Last Name:AUGELLO
Suffix:JR
Gender:M
Credentials:RPH
Other - Prefix:
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Other - Middle Name:
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Mailing Address - Street 1:5890 OLDE ATLANTA PKWY
Mailing Address - Street 2:
Mailing Address - City:SUWANEE
Mailing Address - State:GA
Mailing Address - Zip Code:30024-3451
Mailing Address - Country:US
Mailing Address - Phone:770-313-2878
Mailing Address - Fax:
Practice Address - Street 1:3945 LAWRENCEVILLE HWY NW
Practice Address - Street 2:
Practice Address - City:LILBURN
Practice Address - State:GA
Practice Address - Zip Code:30047-2817
Practice Address - Country:US
Practice Address - Phone:770-935-0061
Practice Address - Fax:770-935-0069
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-09-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
GA014558183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist