Provider Demographics
NPI:1316468739
Name:GIROUX, SAMANTHA LAUREN (PHARMD)
Entity type:Individual
Prefix:DR
First Name:SAMANTHA
Middle Name:LAUREN
Last Name:GIROUX
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 1:1404 MONTROSE PKWY
Mailing Address - Street 2:
Mailing Address - City:NORCROSS
Mailing Address - State:GA
Mailing Address - Zip Code:30092-2672
Mailing Address - Country:US
Mailing Address - Phone:321-446-0332
Mailing Address - Fax:
Practice Address - Street 1:1601 SANDIFER BLVD
Practice Address - Street 2:
Practice Address - City:SENECA
Practice Address - State:SC
Practice Address - Zip Code:29678-0905
Practice Address - Country:US
Practice Address - Phone:864-885-0889
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-07-06
Last Update Date:2017-07-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC37165183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist