Provider Demographics
NPI:1851053581
Name:RUGGERI, GINA MARIE (PHARMD)
Entity Type:Individual
Prefix:
First Name:GINA
Middle Name:MARIE
Last Name:RUGGERI
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 1:2595 WATERFORD PARK DR
Mailing Address - Street 2:
Mailing Address - City:LAWRENCEVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30044-2731
Mailing Address - Country:US
Mailing Address - Phone:678-600-5845
Mailing Address - Fax:
Practice Address - Street 1:6050 SINGLETON RD
Practice Address - Street 2:
Practice Address - City:NORCROSS
Practice Address - State:GA
Practice Address - Zip Code:30093-1923
Practice Address - Country:US
Practice Address - Phone:770-242-3340
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-10-11
Last Update Date:2021-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARPH033293183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist