Provider Demographics
NPI:1376168435
Name:KAPILOFF, MARSHA (RPH)
Entity Type:Individual
Prefix:
First Name:MARSHA
Middle Name:
Last Name:KAPILOFF
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 1:849 WOODSDALE TER
Mailing Address - Street 2:
Mailing Address - City:MACON
Mailing Address - State:GA
Mailing Address - Zip Code:31210-3225
Mailing Address - Country:US
Mailing Address - Phone:478-972-3903
Mailing Address - Fax:
Practice Address - Street 1:220 TOM HILL SR BLVD
Practice Address - Street 2:
Practice Address - City:MACON
Practice Address - State:GA
Practice Address - Zip Code:31210-1815
Practice Address - Country:US
Practice Address - Phone:478-474-7597
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-06-14
Last Update Date:2020-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA0144061835P0018X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P0018XPharmacy Service ProvidersPharmacistPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist