Provider Demographics
NPI:1982096848
Name:GRINSTEAD, BRITTANI MCLEOD (PHARMD)
Entity Type:Individual
Prefix:MRS
First Name:BRITTANI
Middle Name:MCLEOD
Last Name:GRINSTEAD
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:MISS
Other - First Name:BRITTANI
Other - Middle Name:NICOLE
Other - Last Name:MCLEOD
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PHARMD
Mailing Address - Street 1:PO BOX 65
Mailing Address - Street 2:
Mailing Address - City:HAWKINSVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:31036-0065
Mailing Address - Country:US
Mailing Address - Phone:478-783-4556
Mailing Address - Fax:478-783-4552
Practice Address - Street 1:150 COMMERCE ST
Practice Address - Street 2:
Practice Address - City:HAWKINSVILLE
Practice Address - State:GA
Practice Address - Zip Code:31036-8431
Practice Address - Country:US
Practice Address - Phone:478-783-4556
Practice Address - Fax:478-783-4552
Is Sole Proprietor?:No
Enumeration Date:2015-03-02
Last Update Date:2015-03-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARPH026244183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist