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General NPI Number Information
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NPI Number | 1942588934
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Entity Type | Individual
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Provider Name | HEYWARD WOODWARD JR. R.PH.
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Gender | Male
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Dates
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Enumeration Date | 07/26/2011
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Last Update Date | 07/26/2011
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Provider Practice Location Address
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Address Line | 2240 SALEM RD SE
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City | CONYERS
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State | GA
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Zip | 30013-1843
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Country | US
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Telephone | 770-929-8711
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Fax |
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Provider Business Mailing Address
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Address Line | 1031 MORGAN DR
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City | BUCKHEAD
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State | GA
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Zip | 30625-2223
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Country | US
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Telephone | 706-342-9288
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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 | 13368
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License Number State | GA
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