Provider Demographics
NPI:1679556294
Name:BASCOMBE, MARSHA ROBERTS (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:MARSHA
Middle Name:ROBERTS
Last Name:BASCOMBE
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 1:230 DUNCAN DR
Mailing Address - Street 2:BLDG 1440 STE A148
Mailing Address - City:SAVANNAH
Mailing Address - State:GA
Mailing Address - Zip Code:31409-5107
Mailing Address - Country:US
Mailing Address - Phone:912-315-4540
Mailing Address - Fax:912-315-3614
Practice Address - Street 1:230 DUNCAN DR
Practice Address - Street 2:BLDG 1440 STE A148
Practice Address - City:SAVANNAH
Practice Address - State:GA
Practice Address - Zip Code:31409-5107
Practice Address - Country:US
Practice Address - Phone:912-315-4540
Practice Address - Fax:912-315-3614
Is Sole Proprietor?:No
Enumeration Date:2005-11-29
Last Update Date:2014-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA13348183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist