Provider Demographics
NPI:1649718982
Name:AGUILLARD, LOREN GABRIELLE (PHARM D)
Entity type:Individual
Prefix:DR
First Name:LOREN
Middle Name:GABRIELLE
Last Name:AGUILLARD
Suffix:
Gender:F
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 1:4830 HIGHWAY 9 N
Mailing Address - Street 2:
Mailing Address - City:ALPHARETTA
Mailing Address - State:GA
Mailing Address - Zip Code:30004-2975
Mailing Address - Country:US
Mailing Address - Phone:770-777-0589
Mailing Address - Fax:
Practice Address - Street 1:4830 HIGHWAY 9 N
Practice Address - Street 2:
Practice Address - City:ALPHARETTA
Practice Address - State:GA
Practice Address - Zip Code:30004-2975
Practice Address - Country:US
Practice Address - Phone:770-777-0589
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-02-07
Last Update Date:2017-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARPH029629183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist