Provider Demographics
NPI:1598877235
Name:HOWELL, TRACEY (RPH)
Entity Type:Individual
Prefix:
First Name:TRACEY
Middle Name:
Last Name:HOWELL
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 1:1137 SUMMERFIELD
Mailing Address - Street 2:
Mailing Address - City:CAIRO
Mailing Address - State:GA
Mailing Address - Zip Code:39828-1472
Mailing Address - Country:US
Mailing Address - Phone:229-377-8878
Mailing Address - Fax:
Practice Address - Street 1:2800 OLD DAWSON RD
Practice Address - Street 2:
Practice Address - City:ALBANY
Practice Address - State:GA
Practice Address - Zip Code:31707-1599
Practice Address - Country:US
Practice Address - Phone:229-888-5039
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-31
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA019121183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist