Provider Demographics
NPI:1760634323
Name:TOLER, LAURA (PHARMD)
Entity Type:Individual
Prefix:
First Name:LAURA
Middle Name:
Last Name:TOLER
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 1:701 S PIERCE ST
Mailing Address - Street 2:
Mailing Address - City:ALMA
Mailing Address - State:GA
Mailing Address - Zip Code:31510-3217
Mailing Address - Country:US
Mailing Address - Phone:912-632-6715
Mailing Address - Fax:912-632-1133
Practice Address - Street 1:701 S PIERCE ST
Practice Address - Street 2:
Practice Address - City:ALMA
Practice Address - State:GA
Practice Address - Zip Code:31510-3217
Practice Address - Country:US
Practice Address - Phone:912-632-6715
Practice Address - Fax:912-632-1133
Is Sole Proprietor?:Yes
Enumeration Date:2008-10-15
Last Update Date:2008-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA018840183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist