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Individual

JOHN THOMAS RUST

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
PHARMACIST

Contact information

Practice address
775 GA HIGHWAY 122 W, HAHIRA, GA 31632-1066
(229) 794-2989
Mailing address
1289 FELLOWS RD, ROCHELLE, GA 31079-3907
(229) 324-2882

Taxonomy

Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
RPH031027
GA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
RPH031027
PHARMACIST LICENSE
GA
Enumeration date
01/08/2019
Last updated
01/08/2019
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