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NPI Code Detail

MEDICARE: BAWAYNA THOMPSON THOMPSON

MEDICARE: BAWAYNA THOMPSON THOMPSON
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
11835P2201XAmbulatory Care Pharmacist018052GA

General Provider Information

NPI Number : 1124970934
Entity Type Code : Individual
Provider Name (Legal Business Name) : BAWAYNA THOMPSON THOMPSON
Provider Business Mailing Address
First Line : PO BOX 195
Second Line :
City : OXFORD
State : GA
Zip : 30054-0195
Country : US
Telephone Number : 470-832-0585
Fax Number :
Provider Business Practice Location Address
First Line : 1175 CASCADE PKWY SW
Second Line :
City : ATLANTA
State : GA
Zip : 30311-3090
Country : US
Telephone Number : 678-382-2783
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/12/2026
Last Update Date : 02/12/2026

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Directions to “ BAWAYNA THOMPSON THOMPSON ” Practice Location

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