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NPI Code Detail

MEDICARE: DR. SUSAN ROSEMARY KOREY PHARMD

MEDICARE: DR. SUSAN ROSEMARY KOREY PHARMD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1183500000XPharmacist015369GA

General Provider Information

NPI Number : 1245372309
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. SUSAN ROSEMARY KOREY PHARMD
Provider Business Mailing Address
First Line : 1202 BENBROOKE CT NW
Second Line :
City : ACWORTH
State : GA
Zip : 30101-8489
Country : US
Telephone Number : 678-355-9004
Fax Number :
Provider Business Practice Location Address
First Line : 4797 S MAIN ST
Second Line :
City : ACWORTH
State : GA
Zip : 30101-5339
Country : US
Telephone Number : 770-974-3131
Fax Number : 770-975-9735
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/13/2007
Last Update Date : 07/08/2007

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