Provider Demographics
NPI:1255783601
Name:MATHEWS, NARRIA (PHARMD)
Entity type:Individual
Prefix:
First Name:NARRIA
Middle Name:
Last Name:MATHEWS
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:NARRIA
Other - Middle Name:
Other - Last Name:LOFTIES
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2615 BRITTANY PARK LN
Mailing Address - Street 2:
Mailing Address - City:ELLENWOOD
Mailing Address - State:GA
Mailing Address - Zip Code:30294-6276
Mailing Address - Country:US
Mailing Address - Phone:678-313-7233
Mailing Address - Fax:
Practice Address - Street 1:2615 BRITTANY PARK LN
Practice Address - Street 2:
Practice Address - City:ELLENWOOD
Practice Address - State:GA
Practice Address - Zip Code:30294-6276
Practice Address - Country:US
Practice Address - Phone:678-313-7233
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-07-11
Last Update Date:2016-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARPH023712183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist