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General NPI Number Information
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NPI Number | 1205258514
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Entity Type | Individual
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Provider Name | CLAUDE TOLBERT JR.
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Gender | Male
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Dates
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Enumeration Date | 01/07/2014
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Last Update Date | 06/18/2015
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Provider Practice Location Address
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Address Line | 3278 MITCHELL BLVD
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City | MOODY AFB
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State | GA
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Zip | 31699-1500
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Country | US
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Telephone | 229-257-3321
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Fax |
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Provider Business Mailing Address
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Address Line | 3450 GOLFE LINKS DR
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City | SNELLVILLE
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State | GA
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Zip | 30039-4727
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Country | US
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Telephone | 770-374-5952
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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 | 11549
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License Number State | GA
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