Provider Demographics
NPI:1285971077
Name:MACOY, BARRY WAYNE (PHARMD)
Entity type:Individual
Prefix:DR
First Name:BARRY
Middle Name:WAYNE
Last Name:MACOY
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1200 HIGHWAY 74 S
Mailing Address - Street 2:STE 20
Mailing Address - City:PEACHTREE CITY
Mailing Address - State:GA
Mailing Address - Zip Code:30269-3073
Mailing Address - Country:US
Mailing Address - Phone:770-486-5559
Mailing Address - Fax:770-486-6365
Practice Address - Street 1:1200 HIGHWAY 74 S
Practice Address - Street 2:STE 20
Practice Address - City:PEACHTREE CITY
Practice Address - State:GA
Practice Address - Zip Code:30269-3073
Practice Address - Country:US
Practice Address - Phone:770-486-5559
Practice Address - Fax:770-486-6365
Is Sole Proprietor?:No
Enumeration Date:2013-01-14
Last Update Date:2013-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARPH020497183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist