Provider Demographics
NPI:1841485075
Name:REESE, SHARITA GOLPHIN (PHARMD)
Entity type:Individual
Prefix:DR
First Name:SHARITA
Middle Name:GOLPHIN
Last Name:REESE
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:DR
Other - First Name:SHARITA
Other - Middle Name:LA'KEY
Other - Last Name:GOLPHIN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PHARMD
Mailing Address - Street 1:1670 CLAIRMONT RD
Mailing Address - Street 2:DEPT OF PHARMACY
Mailing Address - City:DECATUR
Mailing Address - State:GA
Mailing Address - Zip Code:30033-4004
Mailing Address - Country:US
Mailing Address - Phone:404-321-6111
Mailing Address - Fax:
Practice Address - Street 1:1670 CLAIRMONT RD
Practice Address - Street 2:DEPT OF PHARMACY
Practice Address - City:DECATUR
Practice Address - State:GA
Practice Address - Zip Code:30033-4004
Practice Address - Country:US
Practice Address - Phone:404-321-6111
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-09-11
Last Update Date:2012-12-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA209761835P1200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P1200XPharmacy Service ProvidersPharmacistPharmacotherapy