Allison Wise Bentley
Individual provider Active NPI Pharmacist · Toccoa, GA
NPI 1366032807 · NPPES record last updated Jan 20, 2021
Key facts
- NPI
- 1366032807
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Pharmacist 183500000X
- License
- 16804 (GA)
- Practice address
- 959 Big a Rd
Toccoa, GA 30577-6026 - Phone
- (706) 886-6876
- NPI assigned
- Jan 19, 2021
- 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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 16804 | GA | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Georgia CVS Pharmacy L.L.C | Past |
Accepting new patients | |
| Georgia CVS Pharmacy LLC | Past |
Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 16804 | GA | Yes |
Addresses
Primary practice location
959 Big a Rd
Toccoa, GA 30577-6026
Mailing address
959 Big a Rd
Toccoa, GA 30577-6026
Phone (706) 886-6876
Other providers in Toccoa, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 20, 2021. 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.