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NPI Code Detail

MEDICARE: DR. KATIE BLALOCK MILLS PHARMD

MEDICARE: DR. KATIE BLALOCK MILLS 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
1183500000XPharmacistRPH024939GA

General Provider Information

NPI Number : 1871875088
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. KATIE BLALOCK MILLS PHARMD
Provider Business Mailing Address
First Line : 4519 DALLAS ACWORTH HWY
Second Line :
City : DALLAS
State : GA
Zip : 30132-7675
Country : US
Telephone Number : 770-443-4988
Fax Number :
Provider Business Practice Location Address
First Line : 4519 DALLAS ACWORTH HWY
Second Line :
City : DALLAS
State : GA
Zip : 30132-7675
Country : US
Telephone Number : 770-443-4988
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/13/2011
Last Update Date : 09/13/2011

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