Healthcare Provider Details

I. General information

NPI: 1164284147
Provider Name (Legal Business Name): AMBER MARIE SPRAYBERRY
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/25/2024
Last Update Date: 06/29/2026
Certification Date: 06/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4975 JIMMY CARTER BLVD
NORCROSS GA
30093-3520
US

IV. Provider business mailing address

2819 BROOKHAVEN VW NE # 2819
BROOKHAVEN GA
30319-5403
US

V. Phone/Fax

Practice location:
  • Phone: 770-225-9906
  • Fax:
Mailing address:
  • Phone: 334-313-6719
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberRPH036270
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: