Provider Demographics
NPI:1104790856
Name:STONE, BILLY
Entity type:Individual
Prefix:
First Name:BILLY
Middle Name:
Last Name:STONE
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 927
Mailing Address - Street 2:
Mailing Address - City:DACULA
Mailing Address - State:GA
Mailing Address - Zip Code:30019-0016
Mailing Address - Country:US
Mailing Address - Phone:770-339-1593
Mailing Address - Fax:770-339-1682
Practice Address - Street 1:2555 2ND AVE
Practice Address - Street 2:
Practice Address - City:DACULA
Practice Address - State:GA
Practice Address - Zip Code:30019-2101
Practice Address - Country:US
Practice Address - Phone:770-339-1593
Practice Address - Fax:770-339-1682
Is Sole Proprietor?:Yes
Enumeration Date:2025-10-03
Last Update Date:2025-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARPH014587183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist