Provider Demographics
NPI:1861739724
Name:OFFENHAUER, DONNA ANNE (PHARMD)
Entity type:Individual
Prefix:
First Name:DONNA
Middle Name:ANNE
Last Name:OFFENHAUER
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 1:1515 RIVER PL
Mailing Address - Street 2:SUITE 180
Mailing Address - City:BRASELTON
Mailing Address - State:GA
Mailing Address - Zip Code:30517-5602
Mailing Address - Country:US
Mailing Address - Phone:770-848-6337
Mailing Address - Fax:770-848-6338
Practice Address - Street 1:1515 RIVER PL
Practice Address - Street 2:SUITE 180
Practice Address - City:BRASELTON
Practice Address - State:GA
Practice Address - Zip Code:30517-5602
Practice Address - Country:US
Practice Address - Phone:770-848-6337
Practice Address - Fax:770-848-6338
Is Sole Proprietor?:No
Enumeration Date:2013-01-12
Last Update Date:2017-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARPH016547183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
GARPH016547OtherSTATE LICENSE