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VIDA AWASOM

>> Pharmacist >> Pharmacy Service Providers

Registrant NPI Number: 1316549173

Individual Registrant:
 VIDA  AWASOM 
Gender: F
Sole Proprietor

Location and contact information for practice:
815 SHUGART RD  DALTON, GA 30720-2433 US
Tel: 706-271-2834  Fax: --

Contact information for business:
582 DAWNVILLE RD NE  DALTON, GA 30721-8411 US
Tel: --  Fax: --

Registration Information:
NPI: 1316549173
Entity Type: Individual

Specialty information:

PrimaryCodeCategory/DescriptionStateLicense Number
Y183500000XPharmacy Service Providers
Pharmacist
GARPH023966

Legacy codes, insurance codes and state license numbers:

IssuerNumberStateType




HEALTH CARE JOBS GA - Page 1



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