Provider Demographics
NPI:1679817829
Name:HAMPTON, RUTH ANITA (RPH)
Entity Type:Individual
Prefix:
First Name:RUTH
Middle Name:ANITA
Last Name:HAMPTON
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 1:4371 S COBB DR SE
Mailing Address - Street 2:
Mailing Address - City:SMYRNA
Mailing Address - State:GA
Mailing Address - Zip Code:30080-6330
Mailing Address - Country:US
Mailing Address - Phone:678-556-0914
Mailing Address - Fax:678-556-0874
Practice Address - Street 1:4371 S COBB DR SE
Practice Address - Street 2:
Practice Address - City:SMYRNA
Practice Address - State:GA
Practice Address - Zip Code:30080-6330
Practice Address - Country:US
Practice Address - Phone:678-556-0914
Practice Address - Fax:678-556-0874
Is Sole Proprietor?:Yes
Enumeration Date:2012-11-11
Last Update Date:2022-12-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH3119195183500000X
GA17527183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist