Provider Demographics
NPI:1285971341
Name:HILLIS, CATHERINE DEVAUGHN (RPH)
Entity type:Individual
Prefix:MS
First Name:CATHERINE
Middle Name:DEVAUGHN
Last Name:HILLIS
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:261 W CLINTON ST
Mailing Address - Street 2:
Mailing Address - City:GRAY
Mailing Address - State:GA
Mailing Address - Zip Code:31032
Mailing Address - Country:US
Mailing Address - Phone:478-986-3592
Mailing Address - Fax:478-986-9968
Practice Address - Street 1:4274 WASHINGTON RD
Practice Address - Street 2:
Practice Address - City:EVANS
Practice Address - State:GA
Practice Address - Zip Code:30809-3070
Practice Address - Country:US
Practice Address - Phone:706-650-5046
Practice Address - Fax:706-650-5055
Is Sole Proprietor?:No
Enumeration Date:2013-01-09
Last Update Date:2017-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARPH014667183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist