Provider Demographics
NPI:1235476128
Name:RAPHAEL, LILKA FINLEY (RPH)
Entity Type:Individual
Prefix:
First Name:LILKA
Middle Name:FINLEY
Last Name:RAPHAEL
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13015 BROWN BRIDGE RD
Mailing Address - Street 2:
Mailing Address - City:COVINGTON
Mailing Address - State:GA
Mailing Address - Zip Code:30016-9111
Mailing Address - Country:US
Mailing Address - Phone:678-342-6939
Mailing Address - Fax:678-342-7979
Practice Address - Street 1:13015 BROWN BRIDGE RD
Practice Address - Street 2:
Practice Address - City:COVINGTON
Practice Address - State:GA
Practice Address - Zip Code:30016-9111
Practice Address - Country:US
Practice Address - Phone:678-342-6939
Practice Address - Fax:678-342-7979
Is Sole Proprietor?:No
Enumeration Date:2013-01-11
Last Update Date:2013-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARPH018624183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist