Thaddeus A Blue, PHARMD Valid NPI
Individual provider · Pharmacist · Mableton, GA
- NPI
- 1770807661
- Type
- Individual (Type 1)
- Primary specialty
- Pharmacist
- Specialty group
- Pharmacy Service Providers
- Taxonomy code
- 183500000X
- License number
- 019367 (GA)
- Sex
- Male
- Sole proprietor
- No
- Enumerated
- 2010-03-21
- Last updated
- 2010-03-21
Practice location
1153 Vinings Place Way Se
Mableton, GA 30126-5671
(678) 933-1711