Provider Demographics
NPI:1962099697
Name:SWINDELL, BRIANNA (PHARMD)
Entity type:Individual
Prefix:
First Name:BRIANNA
Middle Name:
Last Name:SWINDELL
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:BRIANNA
Other - Middle Name:
Other - Last Name:WATKINS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:201 MILLSTONE WAY
Mailing Address - Street 2:
Mailing Address - City:BONAIRE
Mailing Address - State:GA
Mailing Address - Zip Code:31005-3057
Mailing Address - Country:US
Mailing Address - Phone:478-231-1371
Mailing Address - Fax:
Practice Address - Street 1:1221 PLAZA AVE STE C
Practice Address - Street 2:
Practice Address - City:EASTMAN
Practice Address - State:GA
Practice Address - Zip Code:31023-9011
Practice Address - Country:US
Practice Address - Phone:478-374-6670
Practice Address - Fax:478-374-6674
Is Sole Proprietor?:No
Enumeration Date:2020-12-29
Last Update Date:2020-12-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARHP032044183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist