Healthcare Provider Details

I. General information

NPI: 1417940107
Provider Name (Legal Business Name): DEBBIE LYNN TARLTON R.PH.
Entity Type: Individual
Gender: Female
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 08/26/2005
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1000 JOHNSON FERRY RD NE
ATLANTA GA
30342-1606
US

IV. Provider business mailing address

4023 DREAM CATCHER DR
WOODSTOCK GA
30189-2540
US

V. Phone/Fax

Practice location:
  • Phone: 404-851-8902
  • Fax:
Mailing address:
  • Phone: 770-924-4463
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number017799
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: