Healthcare Provider Details

I. General information

NPI: 1912902743
Provider Name (Legal Business Name): ANDREW THOMAS TAYLOR PHARM.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/17/2005
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1120 15TH ST
AUGUSTA GA
30912-0004
US

IV. Provider business mailing address

4799 HEREFORD FARM RD
EVANS GA
30809-6037
US

V. Phone/Fax

Practice location:
  • Phone: 706-721-4915
  • Fax: 706-721-3994
Mailing address:
  • Phone: 706-860-4060
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberRPH011427
License Number StateGA
# 2
Primary TaxonomyN
Taxonomy Code1835P1200X
TaxonomyPharmacotherapy Pharmacist
License NumberRPH011427
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: