Provider Demographics
NPI:1659775864
Name:HILLYARD, MAGAN OGDEN (PHARMD)
Entity Type:Individual
Prefix:MRS
First Name:MAGAN
Middle Name:OGDEN
Last Name:HILLYARD
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 1:14 EAGLE DR
Mailing Address - Street 2:
Mailing Address - City:JESUP
Mailing Address - State:GA
Mailing Address - Zip Code:31546-2131
Mailing Address - Country:US
Mailing Address - Phone:912-294-0981
Mailing Address - Fax:912-530-6169
Practice Address - Street 1:101 PEACHTREE ST
Practice Address - Street 2:
Practice Address - City:JESUP
Practice Address - State:GA
Practice Address - Zip Code:31545-0211
Practice Address - Country:US
Practice Address - Phone:912-427-8825
Practice Address - Fax:912-530-6169
Is Sole Proprietor?:No
Enumeration Date:2014-10-17
Last Update Date:2014-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARPH026231183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist