Provider Demographics
NPI:1154951440
Name:ROWLAND, ALICE ALDEN
Entity type:Individual
Prefix:
First Name:ALICE
Middle Name:ALDEN
Last Name:ROWLAND
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1685 OLD PENDERGRASS RD
Mailing Address - Street 2:
Mailing Address - City:JEFFERSON
Mailing Address - State:GA
Mailing Address - Zip Code:30549-2705
Mailing Address - Country:US
Mailing Address - Phone:706-387-7620
Mailing Address - Fax:706-387-7622
Practice Address - Street 1:1685 OLD PENDERGRASS RD
Practice Address - Street 2:
Practice Address - City:JEFFERSON
Practice Address - State:GA
Practice Address - Zip Code:30549-2705
Practice Address - Country:US
Practice Address - Phone:706-387-7620
Practice Address - Fax:706-387-7622
Is Sole Proprietor?:No
Enumeration Date:2020-01-25
Last Update Date:2020-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA147171835P0018X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P0018XPharmacy Service ProvidersPharmacistPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist