Carol Demersseman
Individual provider Active NPI Pharmacist · Oakwood, GA
NPI 1497355374 · NPPES record last updated Oct 29, 2020
Key facts
- NPI
- 1497355374
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Pharmacist 183500000X
- License
- 018171 (GA)
- Practice address
- 3839 Mundy Mill Rd
Oakwood, GA 30566-3415 - Phone
- (770) 532-5772
- NPI assigned
- Oct 29, 2020
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|
| 018171 | GA | MD | Pharmacist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 018171 | GA | Yes |
Addresses
Primary practice location
3839 Mundy Mill Rd
Oakwood, GA 30566-3415
Mailing address
3839 Mundy Mill Rd
Oakwood, GA 30566-3415
Other providers in Oakwood, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 29, 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.