Kyle A. Banks, RPH

Individual provider Active NPI Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist · Cedartown, GA

NPI 1134488950 · NPPES record last updated May 29, 2026

Key facts

NPI
1134488950
Entity type
Individual (NPI type 1)
Primary specialty
Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist 1835P0018X
License
RPH018686 (GA)
Practice address
730 N Main St
Cedartown, GA 30125-2358
Phone
(770) 749-5095
Fax
(770) 749-0228
NPI assigned
May 14, 2012
Sex
Male
Sole proprietor
No

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 and National Provider Directory roles.

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

LicenseStateTypeSpecialty
RPH018686GAMDPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist

Practice roles

OrganizationSpecialtyStatusNew patients
Kroger Co Past Accepting new patients
The Kroger Co Past Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist 1835P0018X RPH018686 GA Yes

Addresses

Primary practice location

730 N Main St
Cedartown, GA 30125-2358

Mailing address

730 N Main St
Cedartown, GA 30125-2358
Phone (770) 749-5095

Other providers in Cedartown, GA

All providers in Cedartown, GA · Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist in Georgia

Sources for this page

Verify at the official NPI Registry.