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NPI Code Detail

MEDICARE: DR. LATASHA STALLWORTH PHARMD

MEDICARE:  DR. LATASHA  STALLWORTH  PHARMD
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
1183500000XPharmacistRPH26521GA

General Provider Information

NPI Number : 1548864671
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. LATASHA STALLWORTH PHARMD
Provider Business Mailing Address
First Line : 1554 N DECATUR RD NE
Second Line :
City : ATLANTA
State : GA
Zip : 30307-1016
Country : US
Telephone Number : 404-373-4534
Fax Number :
Provider Business Practice Location Address
First Line : 1554 N DECATUR RD NE
Second Line :
City : ATLANTA
State : GA
Zip : 30307-1016
Country : US
Telephone Number : 404-373-4534
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/30/2020
Last Update Date : 04/07/2026

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Directions to “ DR. LATASHA STALLWORTH PHARMD” Practice Location

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