Provider Demographics
NPI:1710031315
Name:HILLIARD, CLIFF C (PHARMACIST)
Entity Type:Individual
Prefix:DR
First Name:CLIFF
Middle Name:C
Last Name:HILLIARD
Suffix:
Gender:M
Credentials:PHARMACIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:141 DOGWOOD ST SW
Mailing Address - Street 2:P.O. BOX 10
Mailing Address - City:WARWICK
Mailing Address - State:GA
Mailing Address - Zip Code:31796-5568
Mailing Address - Country:US
Mailing Address - Phone:229-535-6240
Mailing Address - Fax:229-535-6291
Practice Address - Street 1:141 DOGWOOD ST SW
Practice Address - Street 2:
Practice Address - City:WARWICK
Practice Address - State:GA
Practice Address - Zip Code:31796-5568
Practice Address - Country:US
Practice Address - Phone:229-535-6240
Practice Address - Fax:229-535-6291
Is Sole Proprietor?:No
Enumeration Date:2007-01-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA9141183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist