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TRACEY DALE MARTIN PHARMACIST
>> Pharmacist >> Pharmacy Service ProvidersRegistrant NPI Number: 1326253063
Individual Registrant: TRACEY DALE MARTIN PHARMACIST
Gender: M
Not Sole Proprietor
Gender: M
Not Sole Proprietor
Location and contact information for practice:
49 HARRELL ST TRION, GA 30753-1403 US
Tel: 706-734-2481 Fax: 706-734-7787
Tel: 706-734-2481 Fax: 706-734-7787
Contact information for business:
27 MOORE ST TRION, GA 30753-1403 US
Tel: 706-734-2481 Fax: 706-734-7787
Tel: 706-734-2481 Fax: 706-734-7787
Registration Information:
NPI: 1326253063
Entity Type: Individual
Entity Type: Individual
Specialty information:
| Primary | Code | Category/Description | State | License Number |
|---|---|---|---|---|
| Y | 183500000X | Pharmacy Service Providers Pharmacist | GA | RPH023029 |
Legacy codes, insurance codes and state license numbers:
| Issuer | Number | State | Type |
|---|---|---|---|
