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General NPI Number Information
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NPI Number | 1124970934
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Entity Type | Individual
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Provider Name | BAWAYNA THOMPSON THOMPSON
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Gender | Female
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Dates
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Enumeration Date | 02/12/2026
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Last Update Date | 02/12/2026
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Provider Practice Location Address
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Address Line | 1175 CASCADE PKWY SW
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City | ATLANTA
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State | GA
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Zip | 30311-3090
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Country | US
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Telephone | 678-382-2783
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 195
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City | OXFORD
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State | GA
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Zip | 30054-0195
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Country | US
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Telephone | 470-832-0585
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1835P2201X
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Taxonomy Name | Ambulatory Care Pharmacist
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License Number | 018052
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License Number State | GA
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