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Individual
MARCUS LEE HEDRICK
Active
Individual
MARCUS LEE HEDRICK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PHARMACIST
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
GA017240
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
GA017240
GA EPH LOS ENSE
GA
Enumeration date
10/21/2020
Last updated
10/21/2020
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