Provider Demographics
NPI:1255028148
Name:HAMRICK, JOHNATHAN (PHARMD)
Entity type:Individual
Prefix:DR
First Name:JOHNATHAN
Middle Name:
Last Name:HAMRICK
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:660 WHITLOCK AVE NW STE G
Mailing Address - Street 2:
Mailing Address - City:MARIETTA
Mailing Address - State:GA
Mailing Address - Zip Code:30064-3174
Mailing Address - Country:US
Mailing Address - Phone:770-514-1414
Mailing Address - Fax:
Practice Address - Street 1:660 WHITLOCK AVE NW STE G
Practice Address - Street 2:
Practice Address - City:MARIETTA
Practice Address - State:GA
Practice Address - Zip Code:30064-3174
Practice Address - Country:US
Practice Address - Phone:770-514-1414
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-04-20
Last Update Date:2023-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARPH0255641835P2201X, 183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
No1835P2201XPharmacy Service ProvidersPharmacistAmbulatory Care