Provider Demographics
NPI:1790389096
Name:MULLINS, CHRISTOPHER WAYNE (PHARMD)
Entity Type:Individual
Prefix:
First Name:CHRISTOPHER
Middle Name:WAYNE
Last Name:MULLINS
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:450 PEACHTREE PKWY
Mailing Address - Street 2:
Mailing Address - City:CUMMING
Mailing Address - State:GA
Mailing Address - Zip Code:30041-6818
Mailing Address - Country:US
Mailing Address - Phone:770-889-1301
Mailing Address - Fax:
Practice Address - Street 1:450 PEACHTREE PKWY
Practice Address - Street 2:
Practice Address - City:CUMMING
Practice Address - State:GA
Practice Address - Zip Code:30041-6818
Practice Address - Country:US
Practice Address - Phone:770-889-1301
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-11-27
Last Update Date:2020-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARPH032239183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist