Provider Demographics
NPI:1235122995
Name:PASS, DAVID HAROLD (RPH)
Entity type:Individual
Prefix:MR
First Name:DAVID
Middle Name:HAROLD
Last Name:PASS
Suffix:
Gender:M
Credentials:RPH
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Mailing Address - Street 1:6591 GARRETT RD
Mailing Address - Street 2:
Mailing Address - City:BUFORD
Mailing Address - State:GA
Mailing Address - Zip Code:30518-1109
Mailing Address - Country:US
Mailing Address - Phone:770-945-8177
Mailing Address - Fax:770-932-7850
Practice Address - Street 1:1200 NORTHSIDE FORSYTH DR
Practice Address - Street 2:
Practice Address - City:CUMMING
Practice Address - State:GA
Practice Address - Zip Code:30041-7659
Practice Address - Country:US
Practice Address - Phone:770-844-3396
Practice Address - Fax:770-844-3397
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-08-29
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
GARPH012759183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist