Provider Demographics
NPI:1417011552
Name:WEBB, MARTHA ANN (RPH)
Entity Type:Individual
Prefix:MRS
First Name:MARTHA
Middle Name:ANN
Last Name:WEBB
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 1:107 DOYL RD
Mailing Address - Street 2:
Mailing Address - City:BOWERSVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30516-1405
Mailing Address - Country:US
Mailing Address - Phone:706-245-0994
Mailing Address - Fax:
Practice Address - Street 1:26 FRANKLIN SPRINGS ST
Practice Address - Street 2:
Practice Address - City:ROYSTON
Practice Address - State:GA
Practice Address - Zip Code:30662-4109
Practice Address - Country:US
Practice Address - Phone:706-245-7223
Practice Address - Fax:706-245-6727
Is Sole Proprietor?:No
Enumeration Date:2006-12-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARPH012779183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
GARPH012779OtherPHARMACIST