Nichole Abernathy Hasan, PHARMD
Individual provider Active NPI Pharmacist · Oakwood, GA
NPI 1003464538 · NPPES record last updated Aug 28, 2019
Key facts
- NPI
- 1003464538
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Pharmacist 183500000X
- License
- RPH024584 (GA)
- Practice address
- Walmart Pharmacy
3827 Mundy Mill Rd
Oakwood, GA 30566 - Phone
- (770) 535-3702
- NPI assigned
- Aug 28, 2019
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
- Credentials
- Doctor of Pharmacy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| RPH024584 | GA | MD | Pharmacist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | RPH024584 | GA | Yes |
Addresses
Primary practice location
Walmart Pharmacy
3827 Mundy Mill Rd
Oakwood, GA 30566
Mailing address
3480 Tamerton Trce
Buford, GA 30519-4249
Phone (404) 210-6326
Other providers in Oakwood, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 28, 2019. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.