MEDICARE: DR. VALERIA MCINTYRE PHARM. D., R.PH.

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	1835P1200X	Pharmacotherapy Pharmacist	019234	GA

General Provider Information

NPI Number	:	1598756215
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. VALERIA MCINTYRE PHARM. D., R.PH.

Provider Business Mailing Address
First Line	:	323 N 5TH ST
Second Line	:
City	:	GRIFFIN
State	:	GA
Zip	:	30223-3256
Country	:	US
Telephone Number	:	404-275-5559
Fax Number	:	678-603-2043

Provider Business Practice Location Address
First Line	:	323 N 5TH ST
Second Line	:
City	:	GRIFFIN
State	:	GA
Zip	:	30223-3256
Country	:	US
Telephone Number	:	404-275-5559
Fax Number	:	678-603-2043

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

Provider Enumeration Date	:	11/02/2005
Last Update Date	:	04/03/2009

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