Provider Demographics
NPI:1972106151
Name:PRITCHETT TRAMMELL, JENNY EUDORA (PHARMD)
Entity type:Individual
Prefix:DR
First Name:JENNY
Middle Name:EUDORA
Last Name:PRITCHETT TRAMMELL
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:PO BOX 425
Mailing Address - Street 2:
Mailing Address - City:LUTHERSVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30251-0425
Mailing Address - Country:US
Mailing Address - Phone:770-468-9743
Mailing Address - Fax:
Practice Address - Street 1:300 N MORGAN ST
Practice Address - Street 2:
Practice Address - City:LAGRANGE
Practice Address - State:GA
Practice Address - Zip Code:30240-2806
Practice Address - Country:US
Practice Address - Phone:706-882-2971
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-11-19
Last Update Date:2020-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA0229093336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy