Healthcare Provider Details

I. General information

NPI: 1487255139
Provider Name (Legal Business Name): NOAH BELK PHARMD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/07/2020
Last Update Date: 05/21/2026
Certification Date: 05/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2000 HIGHWAY 155 N
MCDONOUGH GA
30252-4802
US

IV. Provider business mailing address

2000 HIGHWAY 155 N
MCDONOUGH GA
30252-4802
US

V. Phone/Fax

Practice location:
  • Phone: 678-379-1010
  • Fax: 678-379-5400
Mailing address:
  • Phone: 678-379-1010
  • Fax: 678-379-5400

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberRPH032121
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: