Provider Demographics
NPI:1255484267
Name:MCLEOD, ANN TAYLOR (RPH)
Entity Type:Individual
Prefix:
First Name:ANN
Middle Name:TAYLOR
Last Name:MCLEOD
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 1:3513 BAKER RD.
Mailing Address - Street 2:SUITE 500
Mailing Address - City:ACWORTH
Mailing Address - State:GA
Mailing Address - Zip Code:30101
Mailing Address - Country:US
Mailing Address - Phone:770-917-0408
Mailing Address - Fax:770-917-0574
Practice Address - Street 1:3513 BAKER RD.
Practice Address - Street 2:SUITE 500
Practice Address - City:ACWORTH
Practice Address - State:GA
Practice Address - Zip Code:30101
Practice Address - Country:US
Practice Address - Phone:770-917-0408
Practice Address - Fax:770-917-0574
Is Sole Proprietor?:No
Enumeration Date:2007-01-21
Last Update Date:2024-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL21788183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist