Provider Demographics
NPI:1235346974
Name:HAMILTON, MARY R (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:MARY
Middle Name:R
Last Name:HAMILTON
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 1:4469 LEMON ST
Mailing Address - Street 2:
Mailing Address - City:ACWORTH
Mailing Address - State:GA
Mailing Address - Zip Code:30101-5418
Mailing Address - Country:US
Mailing Address - Phone:678-236-0400
Mailing Address - Fax:678-236-0404
Practice Address - Street 1:4469 LEMON ST
Practice Address - Street 2:
Practice Address - City:ACWORTH
Practice Address - State:GA
Practice Address - Zip Code:30101-5418
Practice Address - Country:US
Practice Address - Phone:678-236-0400
Practice Address - Fax:678-236-0404
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA00147401835P1200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P1200XPharmacy Service ProvidersPharmacistPharmacotherapy