Provider Demographics
NPI:1194447268
Name:ARRINGTON, DOMONIQUE SIMONE (RPH)
Entity type:Individual
Prefix:
First Name:DOMONIQUE
Middle Name:SIMONE
Last Name:ARRINGTON
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1035 LOWER FAYETTEVILLE RD
Mailing Address - Street 2:
Mailing Address - City:NEWNAN
Mailing Address - State:GA
Mailing Address - Zip Code:30265-1132
Mailing Address - Country:US
Mailing Address - Phone:678-423-8891
Mailing Address - Fax:
Practice Address - Street 1:1035 LOWER FAYETTEVILLE RD
Practice Address - Street 2:
Practice Address - City:NEWNAN
Practice Address - State:GA
Practice Address - Zip Code:30265-1132
Practice Address - Country:US
Practice Address - Phone:678-423-8891
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-09-15
Last Update Date:2022-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA033816183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist