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General NPI Number Information
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NPI Number | 1629840434
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Entity Type | Individual
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Provider Name | AMY LOVELACE RPH
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Gender | Female
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Dates
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Enumeration Date | 10/25/2023
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Last Update Date | 10/25/2023
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Provider Practice Location Address
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Address Line | 355 HIGHWAY 441 S
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City | CLAYTON
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State | GA
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Zip | 30525-5454
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Country | US
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Telephone | 706-212-0581
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Fax |
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Provider Business Mailing Address
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Address Line | 612 CONNECTOR RD
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City | LAKEMONT
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State | GA
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Zip | 30552-2448
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Country | US
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Telephone | 717-585-1214
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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 | RPH034394
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License Number State | GA
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