Healthcare Provider Details

I. General information

NPI: 1477479327
Provider Name (Legal Business Name): LAURA MARIA WOOD CASTILLO PHARMD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

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

III. Provider practice location address

1500 PEACHTREE INDUSTRIAL BLVD STE 140
SUWANEE GA
30024-8489
US

IV. Provider business mailing address

627 MORGAN BAY CT APT 627
SUWANEE GA
30024-3859
US

V. Phone/Fax

Practice location:
  • Phone: 678-335-4441
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberRPH036110
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: