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General NPI Number Information
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NPI Number | 1679858898
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Entity Type | Individual
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Provider Name | EVELYN HENRY RPH
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Gender | Female
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Dates
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Enumeration Date | 10/19/2011
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Last Update Date | 10/19/2011
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Provider Practice Location Address
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Address Line | 2320 N DRUID HILLS RD NE
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City | ATLANTA
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State | GA
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Zip | 30329-3109
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Country | US
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Telephone | 646-715-4688
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 7339
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City | ATLANTA
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State | GA
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Zip | 30357
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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 | RPH024441
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License Number State | GA
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Taxonomy #2
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | PS33319
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License Number State | FL
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Taxonomy #3
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 046617
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License Number State | NY
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