Provider Demographics
NPI:1396034492
Name:HODGES, PEGGY P (RPH)
Entity type:Individual
Prefix:
First Name:PEGGY
Middle Name:P
Last Name:HODGES
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:PEGGY
Other - Middle Name:P
Other - Last Name:HODGES
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:RPH
Mailing Address - Street 1:709 HATCHEE RIDGE RD
Mailing Address - Street 2:
Mailing Address - City:DUBLIN
Mailing Address - State:GA
Mailing Address - Zip Code:31021-0886
Mailing Address - Country:US
Mailing Address - Phone:478-676-4135
Mailing Address - Fax:
Practice Address - Street 1:2000 VETERANS BLVD
Practice Address - Street 2:
Practice Address - City:DUBLIN
Practice Address - State:GA
Practice Address - Zip Code:31021-3030
Practice Address - Country:US
Practice Address - Phone:478-296-7608
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-03-30
Last Update Date:2011-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA15148183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist