Provider Demographics
NPI:1891934261
Name:MCLEMORE, GABRIEL RENARD (PHARMD)
Entity Type:Individual
Prefix:
First Name:GABRIEL
Middle Name:RENARD
Last Name:MCLEMORE
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 1:1204 ANDREWS DR
Mailing Address - Street 2:
Mailing Address - City:LITHIA SPRINGS
Mailing Address - State:GA
Mailing Address - Zip Code:30122-2449
Mailing Address - Country:US
Mailing Address - Phone:404-388-7156
Mailing Address - Fax:404-253-1205
Practice Address - Street 1:60 8TH ST NE
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30309-3959
Practice Address - Country:US
Practice Address - Phone:404-253-1243
Practice Address - Fax:404-253-1205
Is Sole Proprietor?:Yes
Enumeration Date:2009-02-09
Last Update Date:2009-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARPH023322183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist