Mary S. Bates, RPH
Individual provider Active NPI Pharmacist · Winder, GA
NPI 1104979459 · NPPES record last updated Jul 8, 2007
Key facts
- NPI
- 1104979459
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Pharmacist 183500000X
- License
- RPH010198 (GA)
- Practice address
- 17 Monroe Hwy
Winder, GA 30680-7186 - Phone
- (770) 307-2906
- NPI assigned
- Jan 19, 2007
- Sex
- Female
- Sole proprietor
- Yes
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
- Credentials
- Registered Pharmacist
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| RPH010198 | GA | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Publix Super Markets Inc | Past |
Accepting new patients | |
| Publix Super Markets Inc | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | RPH010198 | GA | Yes |
Addresses
Primary practice location
17 Monroe Hwy
Winder, GA 30680-7186
Mailing address
4095 Mount Carmel Church Rd
Monroe, GA 30655-5183
Phone (770) 207-9036
Other providers in Winder, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 8, 2007. 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.