MEDICARE: MRS. AMETA K HARE 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	183500000X	Pharmacist	015417	GA

General Provider Information

NPI Number	:	1831197961
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. AMETA K HARE RPH

Provider Business Mailing Address
First Line	:	604 W AUSTIN DR
Second Line	:
City	:	CHATSWORTH
State	:	GA
Zip	:	30705-2004
Country	:	US
Telephone Number	:	706-517-4007
Fax Number	:	706-226-3786

Provider Business Practice Location Address
First Line	:	1100 E WALNUT AVE
Second Line	:
City	:	DALTON
State	:	GA
Zip	:	30721-4185
Country	:	US
Telephone Number	:	706-278-8813
Fax Number	:	706-226-3786

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

Provider Enumeration Date	:	07/12/2005
Last Update Date	:	07/08/2007

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