MEDICARE: CARLA COOMES SCHAFER RPH

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
1	1835P0018X	Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist	RPH015710	GA

General Provider Information

NPI Number	:	1508497132
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CARLA COOMES SCHAFER RPH

Provider Business Mailing Address
First Line	:	4770 FONTWELL CT
Second Line	:
City	:	SUWANEE
State	:	GA
Zip	:	30024-3335
Country	:	US
Telephone Number	:	678-689-3580
Fax Number	:

Provider Business Practice Location Address
First Line	:	6555 SUGARLOAF PKWY
Second Line	:
City	:	DULUTH
State	:	GA
Zip	:	30097-4930
Country	:	US
Telephone Number	:	770-418-2398
Fax Number	:	770-814-9168

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/02/2020
Last Update Date	:	02/02/2020

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Directions to “ CARLA COOMES SCHAFER RPH” Practice Location

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