Provider Demographics
NPI:1629376215
Name:NADREAU, DONALD ARMOND JR (RPH)
Entity Type:Individual
Prefix:
First Name:DONALD
Middle Name:ARMOND
Last Name:NADREAU
Suffix:JR
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:165 TILLINGHAST TRCE
Mailing Address - Street 2:
Mailing Address - City:NEWNAN
Mailing Address - State:GA
Mailing Address - Zip Code:30265-6000
Mailing Address - Country:US
Mailing Address - Phone:770-683-9235
Mailing Address - Fax:770-683-9235
Practice Address - Street 1:165 TILLINGHAST TRCE
Practice Address - Street 2:
Practice Address - City:NEWNAN
Practice Address - State:GA
Practice Address - Zip Code:30265-6000
Practice Address - Country:US
Practice Address - Phone:770-683-9235
Practice Address - Fax:770-683-9235
Is Sole Proprietor?:No
Enumeration Date:2011-03-04
Last Update Date:2011-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARPH023443183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist