Provider Demographics
NPI:1962093161
Name:MUELLER, CORINNE (RPH)
Entity type:Individual
Prefix:
First Name:CORINNE
Middle Name:
Last Name:MUELLER
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 1:6030 HAMPTON BLUFF WAY
Mailing Address - Street 2:
Mailing Address - City:ROSWELL
Mailing Address - State:GA
Mailing Address - Zip Code:30075-6745
Mailing Address - Country:US
Mailing Address - Phone:727-420-7076
Mailing Address - Fax:
Practice Address - Street 1:6330 ROSWELL RD
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30328-3210
Practice Address - Country:US
Practice Address - Phone:404-255-2131
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-01-30
Last Update Date:2021-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARPH030517183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist