Provider Demographics
NPI:1699464529
Name:ROSS, ALLISON RENEE (PHARMD)
Entity type:Individual
Prefix:DR
First Name:ALLISON
Middle Name:RENEE
Last Name:ROSS
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:170 SHADY ROAD PLZ
Mailing Address - Street 2:
Mailing Address - City:MACON
Mailing Address - State:GA
Mailing Address - Zip Code:31211-7701
Mailing Address - Country:US
Mailing Address - Phone:478-731-0687
Mailing Address - Fax:
Practice Address - Street 1:1615 FOREST HILL RD
Practice Address - Street 2:
Practice Address - City:MACON
Practice Address - State:GA
Practice Address - Zip Code:31210-1602
Practice Address - Country:US
Practice Address - Phone:478-477-6648
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-05-05
Last Update Date:2023-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARPH034167183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist