Provider Demographics
NPI:1851411292
Name:NEUBAUER, CASSANDRA LYNELL (PHARMD)
Entity Type:Individual
Prefix:MRS
First Name:CASSANDRA
Middle Name:LYNELL
Last Name:NEUBAUER
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:1835 TERRACE LAKE DR
Mailing Address - Street 2:
Mailing Address - City:LAWRENCEVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30043-6910
Mailing Address - Country:US
Mailing Address - Phone:678-407-1039
Mailing Address - Fax:770-935-8351
Practice Address - Street 1:2975 LAWRENCEVILLE HWY
Practice Address - Street 2:
Practice Address - City:LAWRENCEVILLE
Practice Address - State:GA
Practice Address - Zip Code:30044-4319
Practice Address - Country:US
Practice Address - Phone:770-925-9500
Practice Address - Fax:770-935-8351
Is Sole Proprietor?:No
Enumeration Date:2007-03-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
GA022326183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist