Provider Demographics
NPI:1740461193
Name:PRICE, JEFFREY S (RPH)
Entity type:Individual
Prefix:MR
First Name:JEFFREY
Middle Name:S
Last Name:PRICE
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:115 SCOTSBURG DR
Mailing Address - Street 2:
Mailing Address - City:WARNER ROBINS
Mailing Address - State:GA
Mailing Address - Zip Code:31088-7999
Mailing Address - Country:US
Mailing Address - Phone:478-633-2479
Mailing Address - Fax:478-633-8825
Practice Address - Street 1:777 HEMLOCK ST
Practice Address - Street 2:AHC PHARMACY HOSPITAL BOX 113
Practice Address - City:MACON
Practice Address - State:GA
Practice Address - Zip Code:31201-2102
Practice Address - Country:US
Practice Address - Phone:478-633-2479
Practice Address - Fax:478-633-8825
Is Sole Proprietor?:Yes
Enumeration Date:2007-11-14
Last Update Date:2007-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAGA015233183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist