Provider Demographics
NPI:1467751693
Name:LONDON, ASHLEY SHERWOOD (PHARMD)
Entity Type:Individual
Prefix:
First Name:ASHLEY
Middle Name:SHERWOOD
Last Name:LONDON
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2604 PEACH ORCHARD RD
Mailing Address - Street 2:
Mailing Address - City:AUGUSTA
Mailing Address - State:GA
Mailing Address - Zip Code:30906-2489
Mailing Address - Country:US
Mailing Address - Phone:706-798-5645
Mailing Address - Fax:706-798-0377
Practice Address - Street 1:3900 WASHINGTON RD
Practice Address - Street 2:
Practice Address - City:MARTINEZ
Practice Address - State:GA
Practice Address - Zip Code:30907
Practice Address - Country:US
Practice Address - Phone:706-868-8084
Practice Address - Fax:706-868-8059
Is Sole Proprietor?:Yes
Enumeration Date:2011-03-28
Last Update Date:2018-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA024883183500000X
SC12616183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist