Tonya Adcock
Individual provider Active NPI Pharmacist · Soperton, GA
NPI 1932676152 · NPPES record last updated Oct 25, 2018
Key facts
- NPI
- 1932676152
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Pharmacist 183500000X
- License
- 017224 (GA)
- Practice address
- 804 Second St
Soperton, GA 30457-2402 - Phone
- (912) 529-2021
- Fax
- (912) 529-2031
- NPI assigned
- Oct 25, 2018
- Sex
- Female
- Sole proprietor
- Yes
Organizations & group practices 1
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 |
|---|---|---|---|
| 017224 | GA | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Dennard Inc | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 017224 | GA | Yes |
Addresses
Primary practice location
804 Second St
Soperton, GA 30457-2402
Mailing address
804 Second St
Soperton, GA 30457-2402
Phone (912) 529-2021
Other providers in Soperton, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 25, 2018. 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.