Provider Demographics
NPI:1528769304
Name:ARQUISOLA, GILLIAN (PHARMD)
Entity type:Individual
Prefix:DR
First Name:GILLIAN
Middle Name:
Last Name:ARQUISOLA
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4168 LAURA ANN PL
Mailing Address - Street 2:
Mailing Address - City:MACON
Mailing Address - State:GA
Mailing Address - Zip Code:31210-4635
Mailing Address - Country:US
Mailing Address - Phone:478-737-1046
Mailing Address - Fax:
Practice Address - Street 1:5900 WATSON BLVD
Practice Address - Street 2:
Practice Address - City:WARNER ROBINS
Practice Address - State:GA
Practice Address - Zip Code:31093-8669
Practice Address - Country:US
Practice Address - Phone:478-953-0429
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-03-17
Last Update Date:2023-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARPH032258183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist