Healthcare Provider Details

I. General information

NPI: 1871303792
Provider Name (Legal Business Name): HUY HO PHARMD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/13/2025
Last Update Date: 06/29/2026
Certification Date: 06/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4628 PRESIDENTIAL PKWY
MACON GA
31206-8708
US

IV. Provider business mailing address

217 OLD BRIDGE RD
WARNER ROBINS GA
31088-1116
US

V. Phone/Fax

Practice location:
  • Phone: 478-405-3915
  • Fax:
Mailing address:
  • Phone: 478-334-7497
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1835P0018X
TaxonomyPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
License NumberRPH035293
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: