Individual provider Active NPI

Sandra Lai Quach, PHARM.D.

  • Pharmacist
  • Fayetteville, GA
National Provider Identifier
1023479334
Registry record updated Mar 14, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
RPH027920 Issued in GA
Practice address
108 Pavilion Pkwy
Fayetteville, GA 30214-4056
Phone
(404) 287-5639
NPI assigned
Mar 14, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 14, 2016

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X RPH027920 GA Primary

Addresses

Primary practice location

108 Pavilion Pkwy
Fayetteville, GA 30214-4056

Mailing address

165 Downing CT
Fayetteville, GA 30214-4093
Phone (404) 287-5639

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Doctor of Pharmacy

State licenses

LicenseStateTypeSpecialty
RPH027920GAMDPharmacist

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1457913600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1457913600000",
    "number": "1023479334",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "165 DOWNING CT",
            "city": "FAYETTEVILLE",
            "state": "GA",
            "postal_code": "302144093",
            "telephone_number": "404-287-5639"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "108 PAVILION PKWY",
            "city": "FAYETTEVILLE",
            "state": "GA",
            "postal_code": "302144056",
            "telephone_number": "404-287-5639"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "QUACH",
        "first_name": "SANDRA",
        "middle_name": "LAI",
        "credential": "PHARM.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-03-14",
        "last_updated": "2016-03-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "GA",
            "license": "RPH027920",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fayetteville, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 14, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.