DR. BOMA AGBOH-STROUDE (NPI# 1104196740) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1104196740 |
| Entity Type | Individual |
| Full Name | DR. BOMA AGBOH-STROUDE |
| Credential | PHARMD, CGP |
| Practice Address |
1401 Johnson Ferry Rd Marietta GA 30062-6495 |
| Practice Telephone | 7702400006 |
| Mailing Telephone | 7702400006 |
| Enumeration Date | 2012-01-11 |
| Last Update Date | 2012-01-11 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1835P0018X |
Pharmacist Specialization: Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist |
23609 | GA | Pharmacy Service Providers |
| N | 1835P0018X |
Pharmacist Specialization: Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist |
03329232 | OH | Pharmacy Service Providers |
| N | 1835P0018X |
Pharmacist Specialization: Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist |
38139 | FL | Pharmacy Service Providers |
| Street Address |
1401 JOHNSON FERRY RD |
| City | MARIETTA |
| State | GA |
| Zip Code | 30062-6495 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1134143910 | Thomas L Haltom | Emergency Medicine | 1401 Johnson Ferry Rd, Suite 390, Marietta, GA 30062-6495 | 2006-07-26 |
| 1144771189 | Luxottica of America Inc. | Eyewear Supplier (Equipment, not the service) | 1401 Johnson Ferry Rd, Marietta, GA 30062-6495 | 2016-10-14 |
| 1861869604 | Ketan Pravinbhai Patel | Pharmacist | 1401 Johnson Ferry Rd, Marietta, GA 30062-6495 | 2015-08-27 |
| 1922352137 | Elizabeth Mccord | Pharmacist | 1401 Johnson Ferry Rd, Marietta, GA 30062-6495 | 2012-11-09 |
| 1649565789 | Mary Anne T Hawkins | Pharmacist | 1401 Johnson Ferry Rd, Marietta, GA 30062-6495 | 2011-06-16 |
| 1396913711 | Jose Goncalves, Od | Optometrist | 1401 Johnson Ferry Rd, Ste 148 B, Marietta, GA 30062-6495 | 2008-02-19 |
| 1952579435 | Marietta Vision Care, Inc. | Optometrist | 1401 Johnson Ferry Rd, Ste 148 B, Marietta, GA 30062-6495 | 2008-02-18 |
| 1013101195 | Georgia Cvs Pharmacy LLC | Durable Medical Equipment & Medical Supplies | 1401 Johnson Ferry Rd, Marietta, GA 30062-6495 | 2007-08-30 |
| 1902937725 | Maximum Motion | Physical Therapist | 1401 Johnson Ferry Rd, Suite 380, Marietta, GA 30062-6495 | 2007-03-07 |
| 1558492280 | Rebecca A Scannaliato | Physical Therapist | 1401 Johnson Ferry Rd, Suite 380, Marietta, GA 30062-6495 | 2007-03-07 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1619578051 | Pamela D Kretzmer | Social Worker | 3855 Shallowford Road, Suite 420, Marietta, GA 30062 | 2020-11-03 |
| 1932714680 | Michelle Chambless | Physical Therapist | Team Rehabilitation Ga01, LLC, 1401 Johnson Ferry Road, Suite 340, Marietta, GA 30062 | 2020-09-10 |
| 1700408887 | Life University | Chiropractor | 1323 Roswell Road, Marietta, GA 30062 | 2020-05-12 |
| 1104451160 | Sno Healthcare Group | Clinic/Center | 2424 Roswell Rd Ste 120, Marietta, GA 30062 | 2020-03-10 |
| 1811536212 | Sandy Plains Dental Group, PC | Dentist | 3460 Sandy Plains Rd, Suite 240, Marietta, GA 30062 | 2020-01-02 |
| 1073159034 | Magdala Tulcie Jodesty-jackson | Social Worker | 4343 Shalloword Road, Building H, Suite 4 Lower Level, Marietta, GA 30062 | 2019-11-25 |
| 1598235178 | Matthew Driggers | Counselor | 4343 Shallowford Rd C2, Marietta, GA 30062 | 2018-11-27 |
| 1750895785 | Emily Grace Minday | Counselor | 4343 Shallowford Road Building C, Suite 1 Lower Level, Marietta, GA 30062 | 2017-11-29 |
| 1477072122 | Jason Lee Amos | Speech-Language Pathologist | 3660 Chestnut Ridge Court, Marietta, GA 30062 | 2017-09-13 |
| 1346761376 | Marian Pomaah Opoku-agyeman | Nurse Practitioner | 4661 Andrea Pointe, Marietta, GA 30062 | 2017-06-29 |
| Find all providers in zip 30062 | ||||
| Taxonomy Code | 1835P0018X |
| Grouping | Pharmacy Service Providers |
| Classification | Pharmacist |
| Specialization | Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist |
| Pharmacist Clinician/Clinical Pharmacy Specialist is a pharmacist with additional training and an expanded scope of practice that may include prescriptive authority, therapeutic management, and disease management. |
| Notes: Source: National Uniform Claim Committee, 2007 [1/1/2008: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1073132676 | Khushboo S Rhodes | Pharmacist | 3101 Roswell Rd Ste 132, Marietta, GA 30062-5523 | 2020-04-14 |
| 1265063143 | Ravi Kumar Kolluri | Pharmacist | 2753 Stone Hall Dr, Marietta, GA 30062-5061 | 2020-01-30 |
| 1629594049 | Andrew D Quach | Pharmacist | 3605 Sandy Plains Rd Ste 200, Marietta, GA 30066-3066 | 2017-08-17 |
| 1437608742 | Houda Aboujamous | Pharmacist | 958 Chestnut Hill Rd Sw, Marietta, GA 30064-2955 | 2016-09-27 |
| 1306445382 | Katherine L Antoniades | Pharmacist | 4880 Lower Roswell Rd, Marietta, GA 30068-4375 | 2020-10-21 |
| 1639777147 | Valerie Elise Neesmith | Pharmacist | 3162 Johnson Ferry Rd, Marietta, GA 30062-7604 | 2020-10-16 |
| 1871191635 | Sarah Murihia | Pharmacist | 1122 Powers Ferry Rd Se, Marietta, GA 30067-5753 | 2020-10-14 |
| 1760080642 | Gabrielle Horne | Pharmacist | 1000 Whitlock Ave Nw, Marietta, GA 30064-5455 | 2020-10-13 |
| 1629686134 | Annie Lee | Pharmacist | 4880 Lower Roswell Rd, Marietta, GA 30068-4375 | 2020-07-21 |
| 1750917761 | Elizabeth Carpenter | Pharmacist | 2100 Roswell Rd, Marietta, GA 30062-0810 | 2020-03-21 |
| Find all providers in MARIETTA | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.