Healthcare Provider Details

I. General information

NPI: 1720275761
Provider Name (Legal Business Name): AMINAH POLLOCK PHARMD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: AMINAH SIMMONS PHARMD

II. Dates (important events)

Enumeration Date: 10/03/2007
Last Update Date: 03/11/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

615 FERN BROOKS DR SW
ATLANTA GA
30331-7281
US

IV. Provider business mailing address

3140 ABBEY DR SW
ATLANTA GA
30331-5467
US

V. Phone/Fax

Practice location:
  • Phone: 404-691-2131
  • Fax:
Mailing address:
  • Phone: 404-427-4984
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberRPH020302
License Number StateGA
# 2
Primary TaxonomyN
Taxonomy Code183500000X
TaxonomyPharmacist
License Number15049
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: