IndividualActive
Andrea Jackson, RPH
NPI 1104854603 · Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist · Decatur, GA
Provider details
- NPI number
- 1104854603
- Entity type
- Individual
- Primary specialty
- Pharmacist Clinician (PhC)/ Clinical Pharmacy SpecialistPharmacy Service Providers
- Credential
- RPH
- Sex
- Female
- Sole proprietor
- No
- License
- 9162 (SC)
Specialties & taxonomies
Pharmacy Service Providers
Pharmacy Service Providers
Pharmacy Service Providers
Practice location
1670 Clairmont Rd
Decatur, GA 30033-4004
Phone: (404) 321-6111
Fax: (404) 728-4707
Approximate (ZIP-level) locationGet directions
Mailing address
8270 Knollbrook Ln
Mcdonough, GA 30253-8513
Registry dates
- Enumerated
- 2006-06-30
- Last updated
- 2012-12-27
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.