Individual
EBONY TATE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHARM D, BCPS, BCGP
Contact information
Practice address
325 W MAIN ST, LOUISVILLE, KY 40202-4254
(480) 213-9024
(502) 405-5345
Mailing address
PO BOX 1602, LAWRENCEVILLE, GA 30046-1602
(480) 213-9024
(502) 405-5345
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
PH-3837
HI
183500000X
Pharmacist
Primary
RPH023154
GA
Other
Enumeration date
01/12/2013
Last updated
01/15/2017
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