Healthcare Provider Details

I. General information

NPI: 1073919247
Provider Name (Legal Business Name): JAMES LEWIS PHARM.D
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/14/2014
Last Update Date: 05/15/2024
Certification Date: 05/15/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

943 PEACHTREE ST NE UNIT 706
ATLANTA GA
30309-3990
US

IV. Provider business mailing address

5670 PEACHTREE DUNWOODY RD SUITE 1100
ATLANTA GA
30342-1699
US

V. Phone/Fax

Practice location:
  • Phone: 770-356-3973
  • Fax:
Mailing address:
  • Phone: 404-851-2395
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1835X0200X
TaxonomyOncology Pharmacist
License Number023863
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: