Active NPI
Synda Dickerson
- Pharmacist
- Lithonia, GA
National Provider Identifier
1023893534
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- RPH034476
- Practice address
- 6671 Covington Hwy
Lithonia, GA 30058-4813 - Phone
- (678) 418-0662
- NPI assigned
- Aug 31, 2023
- Last updated
- Aug 31, 2023
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | RPH034476 | GA | Primary |
Addresses
Primary practice location
6671 Covington Hwy
Lithonia, GA 30058-4813
Mailing address
611 Summer Dr
Sandy Springs, GA 30328-6024
Phone (229) 733-0922
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| RPH034476 | GA | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Walgreen Co | Current | Accepting new patients | |
| Walgreen Co | Past | Accepting new patients |
Locations
6671 Covington Hwy
Stonecrest, GA 30058
Phone (678) 418-0662
Organizations & group practices 2
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1693440000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1693440000000",
"number": "1023893534",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "611 SUMMER DR",
"city": "SANDY SPRINGS",
"state": "GA",
"postal_code": "303286024",
"telephone_number": "229-733-0922"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6671 COVINGTON HWY",
"city": "LITHONIA",
"state": "GA",
"postal_code": "300584813",
"telephone_number": "678-418-0662"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DICKERSON",
"first_name": "SYNDA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2023-08-31",
"last_updated": "2023-08-31",
"certification_date": "2023-08-31",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "GA",
"license": "RPH034476",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Lithonia, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 31, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.