1285913756 NPI number — DR. KRISTIN JANE BIGALKE PHARMD, MBA

Table of content: DR. KRISTIN JANE BIGALKE PHARMD, MBA (NPI 1285913756)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1285913756 NPI number — DR. KRISTIN JANE BIGALKE PHARMD, MBA

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
BIGALKE
Provider First Name:
KRISTIN
Provider Middle Name:
JANE
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
PHARMD, MBA
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
HICKS
Provider Other First Name:
KRISTIN
Provider Other Middle Name:
JANE
Provider Other Name Prefix Text:
DR.
Provider Other Name Suffix Text:
Provider Other Credential Text:
PHARMD, MBA
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1285913756
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
08/15/2011
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 244
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
RINCON
Provider Business Mailing Address State Name:
GA
Provider Business Mailing Address Postal Code:
31326-0244
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
912-655-8173
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
4700 WATERS AVE
Provider Second Line Business Practice Location Address:
DEPARTMENT OF PHARMACY
Provider Business Practice Location Address City Name:
SAVANNAH
Provider Business Practice Location Address State Name:
GA
Provider Business Practice Location Address Postal Code:
31404-6220
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
912-350-8240
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
08/15/2011

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 183500000X , with the licence number:  RPH016862 , registered in the state of GA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)