Provider Demographics
NPI:1275008898
Name:MASTERS, MONICA LEIGH (RPH)
Entity Type:Individual
Prefix:DR
First Name:MONICA
Middle Name:LEIGH
Last Name:MASTERS
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:MONICA
Other - Middle Name:LEIGH
Other - Last Name:HOLCOMB
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2455 SALEM RD SE
Mailing Address - Street 2:
Mailing Address - City:CONYERS
Mailing Address - State:GA
Mailing Address - Zip Code:30013-6316
Mailing Address - Country:US
Mailing Address - Phone:770-922-3507
Mailing Address - Fax:770-922-4498
Practice Address - Street 1:2455 SALEM RD SE
Practice Address - Street 2:
Practice Address - City:CONYERS
Practice Address - State:GA
Practice Address - Zip Code:30013-6316
Practice Address - Country:US
Practice Address - Phone:770-922-3507
Practice Address - Fax:770-922-4498
Is Sole Proprietor?:No
Enumeration Date:2018-10-10
Last Update Date:2018-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARPH030545183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist