Healthcare Provider Details

I. General information

NPI: 1982237384
Provider Name (Legal Business Name): SARAH KELL
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/14/2020
Last Update Date: 06/16/2026
Certification Date: 06/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8776 DALLAS ACWORTH HWY
DALLAS GA
30132-4911
US

IV. Provider business mailing address

8776 DALLAS ACWORTH HWY
DALLAS GA
30132
US

V. Phone/Fax

Practice location:
  • Phone: 678-574-6933
  • Fax:
Mailing address:
  • Phone: 678-574-6933
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1835P0018X
TaxonomyPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
License Number031838
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: