Basic Information
| Provider Information | |||||||||
| NPI: | 1679173900 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | CURBOW | ||||||||
| FirstName: | BRITTANY | ||||||||
| MiddleName: | DIXON | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | PHARMD | ||||||||
| OtherOrganizationName: | |||||||||
| OtherOrganizationType: | |||||||||
| OtherLastName: | DIXO | ||||||||
| OtherFirstName: | BRITTANY | ||||||||
| OtherMiddleName: | KATHERINE | ||||||||
| OtherNamePrefix: | DR. | ||||||||
| OtherNameSuffix: | |||||||||
| OtherCredential: | PHARMD | ||||||||
| OtherLastNameType: | 1 | ||||||||
| Mailing Information | |||||||||
| Address1: | 460 FUSSELL RD | ||||||||
| Address2: | |||||||||
| City: | LEESBURG | ||||||||
| State: | GA | ||||||||
| PostalCode: | 317635209 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2298862158 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 1102 E FRANKLIN ST | ||||||||
| Address2: | |||||||||
| City: | SYLVESTER | ||||||||
| State: | GA | ||||||||
| PostalCode: | 317917186 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2294636009 | ||||||||
| FaxNumber: | 2294636010 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 10/27/2020 | ||||||||
| LastUpdateDate: | 10/27/2020 | ||||||||
| NPIDeactivationReasonCode: | |||||||||
| NPIDeactivationDate: | |||||||||
| NPIReactivationDate: | |||||||||
| ProviderGenderCode: | F | ||||||||
| AuthorizedOfficialLastName: | |||||||||
| AuthorizedOfficialFirstName: | |||||||||
| AuthorizedOfficialMiddleName: | |||||||||
| AuthorizedOfficialTitleorPosition: | |||||||||
| AuthorizedOfficialTelephone: | |||||||||
| IsSoleProprietor: | Y | ||||||||
| IsOrganizationSubpart: | |||||||||
| ParentOrganizationLBN: | |||||||||
| AuthorizedOfficialNamePrefix: | |||||||||
| AuthorizedOfficialNameSuffix: | |||||||||
| AuthorizedOfficialCredential: | |||||||||
| NPICertificationDate: | 10/27/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 183500000X | 024997 | GA | Y | Pharmacy Service Providers | Pharmacist |
No ID Information.