Healthcare Provider Details

I. General information

NPI: 1578812673
Provider Name (Legal Business Name): RASHAD DARBY PHARMD.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/05/2012
Last Update Date: 10/14/2020
Certification Date: 10/14/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1120 15TH ST # BT2601
AUGUSTA GA
30912-0004
US

IV. Provider business mailing address

723 BURCH CREEK DR
GROVETOWN GA
30813-4063
US

V. Phone/Fax

Practice location:
  • Phone: 706-446-1234
  • Fax: 706-721-9505
Mailing address:
  • Phone: 803-522-4350
  • Fax: 706-721-9505

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number010961
License Number StateSC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: