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General NPI Number Information
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NPI Number | 1326700824
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Entity Type | Individual
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Provider Name | DARREN INGRAM PHARM.D
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Gender | Male
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Dates
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Enumeration Date | 10/12/2021
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Last Update Date | 10/12/2021
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Provider Practice Location Address
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Address Line | 1050 COOPER RD
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City | GRAYSON
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State | GA
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Zip | 30017-1503
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Country | US
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Telephone | 678-585-4962
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Fax |
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Provider Business Mailing Address
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Address Line | 12 BELLMORE DR
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City | POUGHKEEPSIE
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State | NY
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Zip | 12603-4602
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Country | US
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Telephone |
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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 | RPH033295
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License Number State | GA
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