Provider Demographics
NPI:1053912600
Name:DUNBAR, RUTH ELLEN (PHARMD)
Entity type:Individual
Prefix:
First Name:RUTH
Middle Name:ELLEN
Last Name:DUNBAR
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 1:4818 GABLESTONE DR
Mailing Address - Street 2:
Mailing Address - City:HOSCHTON
Mailing Address - State:GA
Mailing Address - Zip Code:30548-6290
Mailing Address - Country:US
Mailing Address - Phone:606-524-0772
Mailing Address - Fax:
Practice Address - Street 1:3435 CENTERVILLE HWY
Practice Address - Street 2:
Practice Address - City:SNELLVILLE
Practice Address - State:GA
Practice Address - Zip Code:30039-6117
Practice Address - Country:US
Practice Address - Phone:770-972-3135
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-11-02
Last Update Date:2020-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARPH25840183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist