Individual
RITA ILENRE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHARMD
Contact information
Practice address
194 CHAMPION WAY, HIRAM, GA 30141-5247
(770) 875-1764
Mailing address
194 CHAMPION WAY, HIRAM, GA 30141-5247
(770) 875-1764
Taxonomy
Speciality
Code
Description
License number
State
1835X0200X
Oncology Pharmacist
Primary
RPH031068
GA
Other
Enumeration date
08/03/2020
Last updated
08/03/2020
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