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General NPI Number Information
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NPI Number | 1922412204
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Entity Type | Individual
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Provider Name | DANIELLE MARTINA NAVALTA PHARMD
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Gender | Female
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Dates
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Enumeration Date | 06/16/2014
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Last Update Date | 04/30/2015
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Provider Practice Location Address
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Address Line | 2228 HIGHWAY 54
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City | PEACHTREE CITY
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State | GA
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Zip | 30269-1524
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Country | US
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Telephone | 770-487-6877
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Fax |
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Provider Business Mailing Address
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Address Line | 4101 LAKESIDE WAY
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City | NEWNAN
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State | GA
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Zip | 30265-5605
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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 | RPH027537
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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 | 0202212369
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License Number State | VA
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