Provider Demographics
NPI:1881819340
Name:UNIVERSITY OF GEORGIA
Entity Type:Organization
Organization Name:UNIVERSITY OF GEORGIA
Other - Org Name:THE MEDICATION ACCESS PROGRAM OF THE COLLEGE OF PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:CHARLENE
Authorized Official - Middle Name:J
Authorized Official - Last Name:GARRETT
Authorized Official - Suffix:
Authorized Official - Credentials:CPHT
Authorized Official - Phone:706-721-0131
Mailing Address - Street 1:1120 15TTH STREET
Mailing Address - Street 2:CJ1020
Mailing Address - City:AUGUSTA
Mailing Address - State:GA
Mailing Address - Zip Code:30912
Mailing Address - Country:US
Mailing Address - Phone:706-721-0131
Mailing Address - Fax:706-721-3994
Practice Address - Street 1:1120 15TTH STREET
Practice Address - Street 2:CJ1020
Practice Address - City:AUGUSTA
Practice Address - State:GA
Practice Address - Zip Code:30912
Practice Address - Country:US
Practice Address - Phone:706-721-0131
Practice Address - Fax:706-721-3994
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-17
Last Update Date:2022-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332900000XSuppliersNon-Pharmacy Dispensing Site