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General NPI Number Information
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NPI Number | 1174655229
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Entity Type | Individual
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Provider Name | KARAN TUCKER TUCKER RPH
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Gender | Female
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Dates
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Enumeration Date | 03/12/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 250 LANGLEY DR STE 1131
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City | LAWRENCEVILLE
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State | GA
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Zip | 30045-6932
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Country | US
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Telephone | 800-680-1804
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Fax |
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Provider Business Mailing Address
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Address Line | 1321 ROBINHOOD RD
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City | WATKINSVILLE
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State | GA
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Zip | 30677-1821
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Country | US
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Telephone | 706-540-1031
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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 | 183500000X
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Taxonomy Name | Pharmacist
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License Number | GA014060
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License Number State | GA
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