Provider Demographics
NPI:1497329338
Name:AYIM-DARKO, KWASI GYAN (PHARMD)
Entity Type:Individual
Prefix:
First Name:KWASI
Middle Name:GYAN
Last Name:AYIM-DARKO
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3615 LINDSY BROOKE CT
Mailing Address - Street 2:
Mailing Address - City:DOUGLASVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30135-3094
Mailing Address - Country:US
Mailing Address - Phone:404-988-1322
Mailing Address - Fax:
Practice Address - Street 1:3615 LINDSY BROOKE CT
Practice Address - Street 2:
Practice Address - City:DOUGLASVILLE
Practice Address - State:GA
Practice Address - Zip Code:30135-3094
Practice Address - Country:US
Practice Address - Phone:404-988-1322
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-05-15
Last Update Date:2021-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA022898183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist