Kevin Joseph Woody

Individual provider Active NPI Pharmacist · Clermont, GA

NPI 1992394142 · NPPES record last updated Jan 12, 2021

Key facts

NPI
1992394142
Entity type
Individual (NPI type 1)
Primary specialty
Pharmacist 183500000X
License
RPH018454 (GA)
Practice address
5226 Dahlonega Hwy
Clermont, GA 30527-1946
Phone
(770) 983-3510
Fax
(770) 983-7986
NPI assigned
Jan 12, 2021
Sex
Male
Sole proprietor
No

Organizations & group practices 3

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.

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
RPH018454GAMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Woody'S Pharmacy, Inc. Pharmacist Current
since Jan 17, 2021
Accepting new patients
Woodys Longbranch Pharmacy Inc Current Accepting new patients
Woodys Longbranch Pharmacy Inc Current Accepting new patients

Locations

5226 Dahlonega Hwy
Clermont, GA 30527
Phone (770) 983-3510

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X RPH018454 GA Yes

Addresses

Primary practice location

5226 Dahlonega Hwy
Clermont, GA 30527-1946

Mailing address

PO Box 439
Clermont, GA 30527-0439
Phone (770) 983-3510

Other providers in Clermont, GA

All providers in Clermont, GA · Pharmacist in Georgia

Sources for this page

Verify at the official NPI Registry.