Provider Demographics
NPI:1407194756
Name:MAYS, REBECCA SHEAD (PHARMD)
Entity Type:Individual
Prefix:MRS
First Name:REBECCA
Middle Name:SHEAD
Last Name:MAYS
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:MRS
Other - First Name:REBECCA
Other - Middle Name:LYNN
Other - Last Name:STROBLE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PHARMD
Mailing Address - Street 1:125 CARLTON DR
Mailing Address - Street 2:
Mailing Address - City:LEESBURG
Mailing Address - State:GA
Mailing Address - Zip Code:31763-5652
Mailing Address - Country:US
Mailing Address - Phone:229-814-8443
Mailing Address - Fax:229-814-8444
Practice Address - Street 1:125 CARLTON DR
Practice Address - Street 2:
Practice Address - City:LEESBURG
Practice Address - State:GA
Practice Address - Zip Code:31763-5652
Practice Address - Country:US
Practice Address - Phone:229-814-8443
Practice Address - Fax:229-814-8444
Is Sole Proprietor?:Yes
Enumeration Date:2013-01-22
Last Update Date:2021-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAPHRE0109373336C0003X
GARPH020550183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
No3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA003251769AMedicaid