Samaneh Amelrahattalab
Individual provider Active NPI Pharmacist · Woodstock, GA
NPI 1932089018 · NPPES record last updated Sep 8, 2025
Key facts
- NPI
- 1932089018
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Pharmacist 183500000X
- License
- RPH033492 (GA)
- Practice address
- 270 Heritage Walk
Woodstock, GA 30188-3875 - Phone
- (310) 647-7586
- NPI assigned
- Sep 8, 2025
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|
| RPH033492 | GA | MD | Pharmacist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | RPH033492 | GA | Yes |
Addresses
Primary practice location
270 Heritage Walk
Woodstock, GA 30188-3875
Mailing address
1830 Montcliff Dr
Cumming, GA 30041-9370
Phone (310) 647-7586
Other providers in Woodstock, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 8, 2025. 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.