Provider Demographics
NPI:1982940375
Name:MCEVER, ASHLEY KHAN
Entity Type:Individual
Prefix:
First Name:ASHLEY
Middle Name:KHAN
Last Name:MCEVER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:141 W LAKEVIEW LN NE
Mailing Address - Street 2:
Mailing Address - City:MILLEDGEVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:31061-7831
Mailing Address - Country:US
Mailing Address - Phone:678-777-0416
Mailing Address - Fax:
Practice Address - Street 1:295 HAMMOCK RD NW
Practice Address - Street 2:
Practice Address - City:MILLEDGEVILLE
Practice Address - State:GA
Practice Address - Zip Code:31061-2352
Practice Address - Country:US
Practice Address - Phone:478-453-7228
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-12-12
Last Update Date:2012-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARPH026632183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist