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General NPI Number Information
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NPI Number | 1922498401
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Entity Type | Individual
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Provider Name | AMANDA PAISLEY PHARMD
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Gender | Female
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Dates
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Enumeration Date | 02/04/2015
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Last Update Date | 02/04/2015
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Provider Practice Location Address
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Address Line | 4430 WADE GREEN RD NW
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City | KENNESAW
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State | GA
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Zip | 30144-1267
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Country | US
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Telephone | 770-419-4030
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Fax |
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Provider Business Mailing Address
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Address Line | 4248 GLENLAKE PKWY NW
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City | KENNESAW
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State | GA
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Zip | 30144-7139
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Country | US
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Telephone | 404-580-3075
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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 | 026039
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License Number State | GA
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