MEDICARE: CHERYL BOLMON

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	183700000X	Pharmacy Technician	PHTC000627	GA

General Provider Information

NPI Number	:	1851249106
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CHERYL BOLMON

Provider Business Mailing Address
First Line	:	58 BIG A RD STE 101
Second Line	:
City	:	TOCCOA
State	:	GA
Zip	:	30577-6038
Country	:	US
Telephone Number	:	706-886-2151
Fax Number	:	706-297-7519

Provider Business Practice Location Address
First Line	:	58 BIG A RD STE 101
Second Line	:
City	:	TOCCOA
State	:	GA
Zip	:	30577-6038
Country	:	US
Telephone Number	:	706-886-2151
Fax Number	:	706-297-7519

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

Provider Enumeration Date	:	03/20/2026
Last Update Date	:	03/20/2026

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Directions to “ CHERYL BOLMON ” Practice Location

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