Amy Locklear
Individual provider Active NPI Pharmacist · Tallapoosa, GA
NPI 1104429976 · NPPES record last updated Nov 16, 2020
Key facts
- NPI
- 1104429976
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Pharmacist 183500000X
- License
- 022078 (GA)
- Practice address
- 107 Spring St
Tallapoosa, GA 30176-1293 - Phone
- (770) 574-2914
- NPI assigned
- Nov 16, 2020
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 2
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 022078 | GA | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Georgia CVS Pharmacy L.L.C | Past |
Accepting new patients | |
| Georgia CVS Pharmacy, L.L.C. | Past |
Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 022078 | GA | Yes |
Addresses
Primary practice location
107 Spring St
Tallapoosa, GA 30176-1293
Mailing address
107 Spring St
Tallapoosa, GA 30176-1293
Other providers in Tallapoosa, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Nov 16, 2020. 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.