Provider Demographics
NPI:1124502901
Name:WATKINS, CLAIRE ELAINE (PHARMD)
Entity type:Individual
Prefix:DR
First Name:CLAIRE
Middle Name:ELAINE
Last Name:WATKINS
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:101 BLUE MOON XING
Mailing Address - Street 2:
Mailing Address - City:POOLER
Mailing Address - State:GA
Mailing Address - Zip Code:31322-9797
Mailing Address - Country:US
Mailing Address - Phone:912-348-6027
Mailing Address - Fax:
Practice Address - Street 1:101 BLUE MOON XING
Practice Address - Street 2:
Practice Address - City:POOLER
Practice Address - State:GA
Practice Address - Zip Code:31322-9797
Practice Address - Country:US
Practice Address - Phone:912-348-6027
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-09-18
Last Update Date:2018-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA030957183500000X
SC37964183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist