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MR. RAPHAEL AYEGBA AGBALI R.PH
>> Pharmacist >> Pharmacy Service ProvidersRegistrant NPI Number: 1518118900
Individual Registrant:MR. RAPHAEL AYEGBA AGBALI R.PH
Gender: M
Not Sole Proprietor
Gender: M
Not Sole Proprietor
Location and contact information for practice:
3200 N ASHLEY ST VALDOSTA, GA 31602-5912 US
Tel: 229-242-3007 Fax: 229-242-5831
Tel: 229-242-3007 Fax: 229-242-5831
Contact information for business:
3200 N ASHLEY ST VALDOSTA, GA 31602-5912 US
Tel: 229-242-3007 Fax: 229-242-5831
Tel: 229-242-3007 Fax: 229-242-5831
Registration Information:
NPI: 1518118900
Entity Type: Individual
Entity Type: Individual
Specialty information:
| Primary | Code | Category/Description | State | License Number |
|---|---|---|---|---|
| Y | 183500000X | Pharmacy Service Providers Pharmacist | GA | 024485 |
Legacy codes, insurance codes and state license numbers:
| Issuer | Number | State | Type |
|---|---|---|---|
