Provider Demographics
NPI:1336434042
Name:NORMAN, JULIE R (PHARMD)
Entity Type:Individual
Prefix:
First Name:JULIE
Middle Name:R
Last Name:NORMAN
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 1:2195 HIGHWAY 20 SE
Mailing Address - Street 2:T-2174
Mailing Address - City:CONYERS
Mailing Address - State:GA
Mailing Address - Zip Code:30013-2028
Mailing Address - Country:US
Mailing Address - Phone:770-785-6471
Mailing Address - Fax:770-761-1045
Practice Address - Street 1:2195 HIGHWAY 20 SE
Practice Address - Street 2:T-2174
Practice Address - City:CONYERS
Practice Address - State:GA
Practice Address - Zip Code:30013-2028
Practice Address - Country:US
Practice Address - Phone:770-785-6471
Practice Address - Fax:770-761-1045
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
GARPH025424183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist