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TRACEY DALE MARTIN PHARMACIST

>> Pharmacist >> Pharmacy Service Providers

Registrant NPI Number: 1326253063

Individual Registrant:
 TRACEY DALE MARTIN PHARMACIST
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

Contact information for business:
27 MOORE ST  TRION, GA 30753-1403 US
Tel: 706-734-2481  Fax: 706-734-7787

Registration Information:
NPI: 1326253063
Entity Type: Individual

Specialty information:

PrimaryCodeCategory/DescriptionStateLicense Number
Y183500000XPharmacy Service Providers
Pharmacist
GARPH023029

Legacy codes, insurance codes and state license numbers:

IssuerNumberStateType




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