Provider Demographics
NPI:1194747683
Name:JOHNSON, ALMA BANGS (RPH)
Entity type:Individual
Prefix:MRS
First Name:ALMA
Middle Name:BANGS
Last Name:JOHNSON
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 1:2325 CHESHIRE BRIDGE RD NE
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30324-3733
Mailing Address - Country:US
Mailing Address - Phone:404-638-1905
Mailing Address - Fax:404-638-1910
Practice Address - Street 1:2325 CHESHIRE BRIDGE RD NE
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30324-3733
Practice Address - Country:US
Practice Address - Phone:404-638-1905
Practice Address - Fax:404-638-1910
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-24
Last Update Date:2010-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA17558183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist