Provider Demographics
NPI:1184223265
Name:YIMER, SOLOMON AYALEW (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:SOLOMON
Middle Name:AYALEW
Last Name:YIMER
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 1:107 KATHRYN DR
Mailing Address - Street 2:
Mailing Address - City:MARIETTA
Mailing Address - State:GA
Mailing Address - Zip Code:30066-3417
Mailing Address - Country:US
Mailing Address - Phone:678-316-5765
Mailing Address - Fax:
Practice Address - Street 1:4715 S ATLANTA RD SE
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30339-1531
Practice Address - Country:US
Practice Address - Phone:404-792-6980
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-10-20
Last Update Date:2020-10-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARPH026422183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist