Provider Demographics
NPI:1942565858
Name:GRISWOLD, KAROLINA KAY (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:KAROLINA
Middle Name:KAY
Last Name:GRISWOLD
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 1:2205 HARRISON RD
Mailing Address - Street 2:PHARMACY DEPARTMENT
Mailing Address - City:THOMSON
Mailing Address - State:GA
Mailing Address - Zip Code:30824-7455
Mailing Address - Country:US
Mailing Address - Phone:706-595-0180
Mailing Address - Fax:
Practice Address - Street 1:2205 HARRISON RD
Practice Address - Street 2:PHARMACY DEPARTMENT
Practice Address - City:THOMSON
Practice Address - State:GA
Practice Address - Zip Code:30824-7455
Practice Address - Country:US
Practice Address - Phone:706-595-0180
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-07-06
Last Update Date:2016-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPH60290716183500000X
AK2154183500000X
AZS021137183500000X
SCPH.36384183500000X
GARPH028959183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist