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General NPI Number Information
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NPI Number | 1548024979
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Entity Type | Individual
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Provider Name | SHAWN KONWICK PHARM.D.
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Gender | Male
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Dates
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Enumeration Date | 02/07/2024
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Last Update Date | 02/07/2024
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Provider Practice Location Address
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Address Line | 150 HIGHWAY 41
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City | RINGGOLD
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State | GA
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Zip | 30736-8525
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Country | US
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Telephone | 706-891-2610
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Fax |
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Provider Business Mailing Address
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Address Line | 996 JAYS WAY
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City | RINGGOLD
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State | GA
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Zip | 30736-8981
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Country | US
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Telephone | 678-634-6495
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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 | RPH021633
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License Number State | GA
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