Provider Demographics
NPI:1205173069
Name:PILCHER, DORIAN ELISE (PHARMD)
Entity type:Individual
Prefix:DR
First Name:DORIAN
Middle Name:ELISE
Last Name:PILCHER
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 1:12424 CUMMING HWY
Mailing Address - Street 2:
Mailing Address - City:CANTON
Mailing Address - State:GA
Mailing Address - Zip Code:30115-7778
Mailing Address - Country:US
Mailing Address - Phone:678-455-0211
Mailing Address - Fax:678-455-0459
Practice Address - Street 1:12424 CUMMING HWY
Practice Address - Street 2:
Practice Address - City:CANTON
Practice Address - State:GA
Practice Address - Zip Code:30115-7778
Practice Address - Country:US
Practice Address - Phone:678-455-0211
Practice Address - Fax:678-455-0459
Is Sole Proprietor?:No
Enumeration Date:2013-01-12
Last Update Date:2013-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARPH026155183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
GARPH026155OtherPHARMACY LICENSE