Provider Demographics
NPI:1821610924
Name:TUNEWALD, ALLISON WIMBUSH (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:ALLISON
Middle Name:WIMBUSH
Last Name:TUNEWALD
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 1:540 CAMANO WAY
Mailing Address - Street 2:
Mailing Address - City:MCDONOUGH
Mailing Address - State:GA
Mailing Address - Zip Code:30253-8378
Mailing Address - Country:US
Mailing Address - Phone:706-424-2012
Mailing Address - Fax:
Practice Address - Street 1:5440 HILLANDALE DR
Practice Address - Street 2:
Practice Address - City:LITHONIA
Practice Address - State:GA
Practice Address - Zip Code:30058-4865
Practice Address - Country:US
Practice Address - Phone:770-322-2737
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-05-12
Last Update Date:2022-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARPH024538183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist