Provider Demographics
NPI:1932483039
Name:BREURE, DENISE ROCHELLE CHARMAINE (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:DENISE
Middle Name:ROCHELLE CHARMAINE
Last Name:BREURE
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:DENISE
Other - Middle Name:ROCHELLE CHARMAINE
Other - Last Name:GODET
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PHARMD
Mailing Address - Street 1:4051 E SPRING MEADOW DR
Mailing Address - Street 2:
Mailing Address - City:ACWORTH
Mailing Address - State:GA
Mailing Address - Zip Code:30101-7237
Mailing Address - Country:US
Mailing Address - Phone:404-906-3343
Mailing Address - Fax:
Practice Address - Street 1:4051 E SPRING MEADOW DR
Practice Address - Street 2:
Practice Address - City:ACWORTH
Practice Address - State:GA
Practice Address - Zip Code:30101-7237
Practice Address - Country:US
Practice Address - Phone:404-906-3343
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-10-06
Last Update Date:2011-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARPH023829183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
GARPH023829OtherSTATE BORAD