Provider Demographics
NPI:1568754190
Name:MACMAHON, JAMES WALKER (RPH)
Entity Type:Individual
Prefix:MR
First Name:JAMES
Middle Name:WALKER
Last Name:MACMAHON
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4815 CANTON RD
Mailing Address - Street 2:
Mailing Address - City:MARIETTA
Mailing Address - State:GA
Mailing Address - Zip Code:30066-3251
Mailing Address - Country:US
Mailing Address - Phone:678-494-9937
Mailing Address - Fax:678-494-3487
Practice Address - Street 1:4815 CANTON RD
Practice Address - Street 2:
Practice Address - City:MARIETTA
Practice Address - State:GA
Practice Address - Zip Code:30066-3251
Practice Address - Country:US
Practice Address - Phone:678-494-9937
Practice Address - Fax:678-494-3487
Is Sole Proprietor?:Yes
Enumeration Date:2011-05-16
Last Update Date:2011-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARPH009322183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist