Healthcare Provider Details

I. General information

NPI: 1063460475
Provider Name (Legal Business Name): ALLCARE PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/05/2006
Last Update Date: 05/07/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

112 S OXLEY DR
LYONS GA
30436-5645
US

IV. Provider business mailing address

112 S OXLEY DR
LYONS GA
30436-5645
US

V. Phone/Fax

Practice location:
  • Phone: 912-526-3200
  • Fax: 912-526-6830
Mailing address:
  • Phone: 912-526-3200
  • Fax: 912-526-6830

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberPHRE008278
License Number StateGA

VIII. Authorized Official

Name: MR. THOMAS TRENT AKINS
Title or Position: OWNER
Credential: RPH
Phone: 912-526-3200