Provider Demographics
NPI:1124313812
Name:BRITE, JEROME R III (PHARM D)
Entity type:Individual
Prefix:DR
First Name:JEROME
Middle Name:R
Last Name:BRITE
Suffix:III
Gender:M
Credentials:PHARM D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1905 SCENIC HWY N
Mailing Address - Street 2:TARGET-0917
Mailing Address - City:SNELLVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30078-5633
Mailing Address - Country:US
Mailing Address - Phone:678-344-8223
Mailing Address - Fax:678-344-8223
Practice Address - Street 1:1905 SCENIC HWY N
Practice Address - Street 2:TARGET-0917
Practice Address - City:SNELLVILLE
Practice Address - State:GA
Practice Address - Zip Code:30078-5633
Practice Address - Country:US
Practice Address - Phone:678-344-8223
Practice Address - Fax:678-344-8223
Is Sole Proprietor?:Yes
Enumeration Date:2011-06-10
Last Update Date:2011-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA020385183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist