Active NPI
Marla Winge Baltz, PHARMD
- Pharmacist
- Bonaire, GA
National Provider Identifier
1932229242
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 019574
- Practice address
- 785 Hwy. 96
Bonaire, GA 31005 - Phone
- (478) 987-7142
- NPI assigned
- Mar 30, 2007
- Last updated
- Jul 8, 2007
- Sex
- Female
- Sole proprietor
- No
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 | 019574 | GA | Primary |
Addresses
Primary practice location
785 Hwy. 96
Bonaire, GA 31005
Mailing address
160 Waters Edge Dr
Lizella, GA 31052-3629
Phone (478) 935-3507
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1175212800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1932229242",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "160 WATERS EDGE DR",
"city": "LIZELLA",
"state": "GA",
"postal_code": "310523629",
"telephone_number": "478-935-3507"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "785 HWY. 96",
"city": "BONAIRE",
"state": "GA",
"postal_code": "31005",
"telephone_number": "478-987-7142"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BALTZ",
"first_name": "MARLA",
"middle_name": "WINGE",
"name_prefix": "Mrs.",
"credential": "PHARMD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-03-30",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "GA",
"license": "019574",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Bonaire, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.