Provider Demographics
NPI:1578388211
Name:SAMULSKI, HADLEY (PHARMD)
Entity type:Individual
Prefix:
First Name:HADLEY
Middle Name:
Last Name:SAMULSKI
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 1:4793 COUNTRY COVE WAY
Mailing Address - Street 2:
Mailing Address - City:POWDER SPRINGS
Mailing Address - State:GA
Mailing Address - Zip Code:30127-5378
Mailing Address - Country:US
Mailing Address - Phone:586-436-5994
Mailing Address - Fax:
Practice Address - Street 1:660 WHITLOCK AVE SW
Practice Address - Street 2:SUITE G-1
Practice Address - City:MARIETTA
Practice Address - State:GA
Practice Address - Zip Code:30064
Practice Address - Country:US
Practice Address - Phone:770-514-1414
Practice Address - Fax:770-514-8300
Is Sole Proprietor?:No
Enumeration Date:2024-11-18
Last Update Date:2024-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARPH034391183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist