Provider Demographics
NPI:1184199028
Name:ACHEAMPONG, AKOSUA (PHARMD)
Entity Type:Individual
Prefix:
First Name:AKOSUA
Middle Name:
Last Name:ACHEAMPONG
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 1:13 N TENNESSEE ST
Mailing Address - Street 2:
Mailing Address - City:CARTERSVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30120-3339
Mailing Address - Country:US
Mailing Address - Phone:770-386-2417
Mailing Address - Fax:
Practice Address - Street 1:13 N TENNESSEE ST
Practice Address - Street 2:
Practice Address - City:CARTERSVILLE
Practice Address - State:GA
Practice Address - Zip Code:30120-3339
Practice Address - Country:US
Practice Address - Phone:770-386-2417
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-10-08
Last Update Date:2020-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD23740183500000X
GA031868183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist