Provider Demographics
NPI:1598312472
Name:GIRMA, LIDIA (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:LIDIA
Middle Name:
Last Name:GIRMA
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 1:838 MAXEY HILL CT
Mailing Address - Street 2:
Mailing Address - City:STONE MOUNTAIN
Mailing Address - State:GA
Mailing Address - Zip Code:30083-2335
Mailing Address - Country:US
Mailing Address - Phone:404-610-6686
Mailing Address - Fax:
Practice Address - Street 1:1050 E PIEDMONT RD
Practice Address - Street 2:
Practice Address - City:MARIETTA
Practice Address - State:GA
Practice Address - Zip Code:30062-4758
Practice Address - Country:US
Practice Address - Phone:770-509-3986
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-08-24
Last Update Date:2019-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARPH031678183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist