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NPI Code Detail

MEDICARE: CHERYL W. KING

MEDICARE: CHERYL W. KING
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
1183500000XPharmacist5788SC
2183500000XPharmacist16691GA
3183500000XPharmacist11964TN
4183500000XPharmacist15767NC

General Provider Information

NPI Number : 1528343746
Entity Type Code : Individual
Provider Name (Legal Business Name) : CHERYL W. KING
Provider Business Mailing Address
First Line : 2175 PARKLAKE DR NE
Second Line :
City : ATLANTA
State : GA
Zip : 30345-2845
Country : US
Telephone Number : 770-496-7505
Fax Number : 678-261-1470
Provider Business Practice Location Address
First Line : 2175 PARKLAKE DR NE
Second Line :
City : ATLANTA
State : GA
Zip : 30345-2845
Country : US
Telephone Number : 770-496-7505
Fax Number : 678-261-1470
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/19/2011
Last Update Date : 10/19/2011

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