Individual
ELAINE JOINER BIVINS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PHARM.D.
Contact information
Practice address
212 NORTHSIDE DR, VALDOSTA, GA 31602-1858
(229) 242-3060
(229) 316-1366
Mailing address
212 NORTHSIDE DR, VALDOSTA, GA 31602-1858
(229) 242-3060
(229) 316-1366
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
020022
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00339248A
—
GA
Enumeration date
04/21/2009
Last updated
04/21/2009
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