Active NPI
Kwadwo Korsah, PHARM.D.
- Pharmacist
- Dallas, GA
National Provider Identifier
1730538612
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 24111
- Practice address
- 51 Seven Hills Blvd
Dallas, GA 30132-2449 - Phone
- (678) 574-3032
- NPI assigned
- Jun 10, 2016
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | RPH034683 | GA | |
| Pharmacist | 183500000X | 24111 | MD | Primary |
| Pharmacist | 183500000X | 0202214497 | VA |
Addresses
Primary practice location
51 Seven Hills Blvd
Dallas, GA 30132-2449
Mailing address
158 Citrine Way
Acworth, GA 30101-2107
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Pharmacy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| RPH034683 | GA | MD | Pharmacist |
| 24111 | MD | MD | Pharmacist |
| 0202214497 | VA | 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 |
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.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1465516800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1719705600000",
"number": "1730538612",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "158 CITRINE WAY",
"city": "ACWORTH",
"state": "GA",
"postal_code": "301012107"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "51 SEVEN HILLS BLVD",
"city": "DALLAS",
"state": "GA",
"postal_code": "301322449",
"telephone_number": "678-574-3032"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KORSAH",
"first_name": "KWADWO",
"name_prefix": "Dr.",
"credential": "PHARM.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2016-06-10",
"last_updated": "2024-06-30",
"certification_date": "2024-06-30",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "GA",
"license": "RPH034683",
"primary": false
},
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "MD",
"license": "24111",
"primary": true
},
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "VA",
"license": "0202214497",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Dallas, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 30, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.