Provider Demographics
NPI:1295089423
Name:NUNEZ, GUILLERMO ENRIQUE (PHARMD)
Entity type:Individual
Prefix:DR
First Name:GUILLERMO
Middle Name:ENRIQUE
Last Name:NUNEZ
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 1:2420 WISTERIA DR
Mailing Address - Street 2:KMART 3602
Mailing Address - City:SNELLVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30078-6127
Mailing Address - Country:US
Mailing Address - Phone:770-972-1592
Mailing Address - Fax:770-982-5776
Practice Address - Street 1:2420 WISTERIA DR
Practice Address - Street 2:KMART 3602
Practice Address - City:SNELLVILLE
Practice Address - State:GA
Practice Address - Zip Code:30078-6127
Practice Address - Country:US
Practice Address - Phone:770-972-1592
Practice Address - Fax:770-982-5776
Is Sole Proprietor?:No
Enumeration Date:2012-11-09
Last Update Date:2012-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARPH025481183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist