Healthcare Provider Details

I. General information

NPI: 1598756215
Provider Name (Legal Business Name): VALERIA MCINTYRE PHARM. D., R.PH.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/02/2005
Last Update Date: 09/10/2026
Certification Date: 09/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

119 YORK WAY
AUGUSTA GA
30909-6083
US

IV. Provider business mailing address

119 YORK WAY
AUGUSTA GA
30909-6083
US

V. Phone/Fax

Practice location:
  • Phone: 404-275-5559
  • Fax:
Mailing address:
  • Phone: 404-275-5559
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1835P1200X
TaxonomyPharmacotherapy Pharmacist
License Number019234
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: