Healthcare Provider Details

I. General information

NPI: 1356268809
Provider Name (Legal Business Name): DEONDRA SHIPP PHARMD, RPH
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/03/2026
Last Update Date: 07/03/2026
Certification Date: 07/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8601 DUNWOODY PL BLDG 4
SANDY SPRINGS GA
30350-2519
US

IV. Provider business mailing address

1045 OLD PEACHTREE RD NW APT 3406
SUWANEE GA
30024-5079
US

V. Phone/Fax

Practice location:
  • Phone: 943-600-6337
  • Fax:
Mailing address:
  • Phone: 229-894-1999
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberRPH036216
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: