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General NPI Number Information
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NPI Number | 1780860650
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Entity Type | Individual
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Provider Name | TRACY SOMERS WARD R.PH.
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Gender | Female
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Dates
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Enumeration Date | 01/10/2008
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Last Update Date | 01/10/2008
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Provider Practice Location Address
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Address Line | 2175 PARKLAKE DR NE
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City | ATLANTA
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State | GA
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Zip | 30345-2809
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Country | US
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Telephone | 404-790-8951
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Fax | 770-496-7562
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Provider Business Mailing Address
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Address Line | 3083 CAMBRIDGE HILL DR
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City | DACULA
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State | GA
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Zip | 30019-1626
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Country | US
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Telephone | 678-546-7483
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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 | RPH023516
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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 | 11832
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License Number State | NC
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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 | 0202010970
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License Number State | VA
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