Provider Demographics
NPI:1982204517
Name:GRIFFETH, CARINE (PHARMACIST)
Entity Type:Individual
Prefix:
First Name:CARINE
Middle Name:
Last Name:GRIFFETH
Suffix:
Gender:F
Credentials:PHARMACIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:30983 HIGHWAY 441 S
Mailing Address - Street 2:
Mailing Address - City:COMMERCE
Mailing Address - State:GA
Mailing Address - Zip Code:30529-6655
Mailing Address - Country:US
Mailing Address - Phone:706-335-7818
Mailing Address - Fax:706-335-7685
Practice Address - Street 1:30983 HIGHWAY 441 S
Practice Address - Street 2:
Practice Address - City:COMMERCE
Practice Address - State:GA
Practice Address - Zip Code:30529-6655
Practice Address - Country:US
Practice Address - Phone:706-335-7818
Practice Address - Fax:706-335-7685
Is Sole Proprietor?:Yes
Enumeration Date:2020-11-01
Last Update Date:2020-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA015967183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist