Healthcare Provider Details

I. General information

NPI: 1417843319
Provider Name (Legal Business Name): MAKEDA JANELL LOVELACE PHARMD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/16/2025
Last Update Date: 09/02/2026
Certification Date: 09/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7550 COVINGTON HWY
LITHONIA GA
30058-7402
US

IV. Provider business mailing address

3479 VALLEY OAKS RD
STONECREST GA
30038-2761
US

V. Phone/Fax

Practice location:
  • Phone: 770-482-4823
  • Fax:
Mailing address:
  • Phone: 470-505-7015
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberRPH036482
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: