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NPI Code Detail

MEDICARE: MS. KIMBERLY ANN OBELDOBEL

MEDICARE: MS. KIMBERLY ANN OBELDOBEL
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
1183500000XPharmacistRPH022877GA
2183500000XPharmacistRP039968LPA

General Provider Information

NPI Number : 1194006957
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. KIMBERLY ANN OBELDOBEL
Provider Business Mailing Address
First Line : 2580 SANDY PLAINS RD
Second Line :
City : MARIETTA
State : GA
Zip : 30066-5798
Country : US
Telephone Number : 770-565-5681
Fax Number :
Provider Business Practice Location Address
First Line : 2580 SANDY PLAINS RD
Second Line :
City : MARIETTA
State : GA
Zip : 30066-5798
Country : US
Telephone Number : 770-565-5681
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/06/2011
Last Update Date : 09/06/2011

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Directions to “ MS. KIMBERLY ANN OBELDOBEL ” Practice Location

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