Healthcare Provider Details

I. General information

NPI: 1871394528
Provider Name (Legal Business Name): PAYTON MUELLER PHARMD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/20/2025
Last Update Date: 03/20/2025
Certification Date: 03/19/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5353 REYNOLDS ST
SAVANNAH GA
31405-6015
US

IV. Provider business mailing address

1825 GROVE POINT RD APT 123
SAVANNAH GA
31419-8524
US

V. Phone/Fax

Practice location:
  • Phone: 912-819-6000
  • Fax:
Mailing address:
  • Phone: 262-623-8716
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberRPH034963
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: