Active NPI
Yonatan Haile
- Pharmacist
- Villa Rica, GA
National Provider Identifier
1912296237
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- RPH024575
- Practice address
- 62 Industrial Blvd
Villa Rica, GA 30180-1545 - Phone
- (770) 459-9660
- NPI assigned
- Apr 7, 2011
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | RPH024575 | GA | Primary |
Addresses
Primary practice location
62 Industrial Blvd
Villa Rica, GA 30180-1545
Mailing address
1475 Mecaslin St NW Apt 7205
Atlanta, GA 30309-2287
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| RPH024575 | GA | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1302134400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1302134400000",
"number": "1912296237",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1475 MECASLIN ST NW APT 7205",
"city": "ATLANTA",
"state": "GA",
"postal_code": "303092287"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "62 INDUSTRIAL BLVD",
"city": "VILLA RICA",
"state": "GA",
"postal_code": "301801545",
"telephone_number": "770-459-9660"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HAILE",
"first_name": "YONATAN",
"name_prefix": "Dr.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2011-04-07",
"last_updated": "2011-04-07",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "GA",
"license": "RPH024575",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Villa Rica, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 7, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.