AMANUEAL WODAJO (NPI# 1952932600) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1952932600 |
| Entity Type | Individual |
| Full Name | AMANUEAL WODAJO |
| Practice Address |
457 Nathan Dean Blvd Dallas GA 30132-4911 |
| Practice Telephone | 7704438776 |
| Practice Fax Number | 7704430653 |
| Mailing Telephone | 7704438776 |
| Mailing Fax Number | 7704430653 |
| Enumeration Date | 2020-01-31 |
| Last Update Date | 2020-01-31 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1835P0018X |
Pharmacist Specialization: Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist |
PHRE008944 | GA | Pharmacy Service Providers |
| Street Address |
457 NATHAN DEAN BLVD |
| City | DALLAS |
| State | GA |
| Zip Code | 30132-4911 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1093730871 | The Kroger Co | Durable Medical Equipment & Medical Supplies | 457 Nathan Dean Blvd, Dallas, GA 30132-4911 | 2006-07-13 |
| 1982203113 | Katherine Ann Anderson | Pharmacist | 457 Nathan Dean Blvd, Dallas, GA 30132-4911 | 2020-10-19 |
| 1982237384 | Sarah Ehorn | Pharmacist | 457 Nathan Dean Blvd, Dallas, GA 30132-4911 | 2020-02-14 |
| 1235760430 | Jeffrey Rakestraw | Pharmacist | 457 Nathan Dean Blvd, Dallas, GA 30132-4911 | 2020-01-28 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1205398526 | Away Lice Removal Specialists, LLC | Homeopath | 531 Hardee Street, Dallas, GA 30132 | 2019-04-04 |
| 1306313184 | Jessica Ramskogler | Counselor | 168 N. Johnson St, Suite 304, Dallas, GA 30132 | 2018-10-30 |
| 1912489337 | Michelle Jennifer Bergman | Lactation Consultant, Non-RN | 549 Waburn Walk, Dallas, GA 30132 | 2018-09-01 |
| 1457870099 | Dynamic Xray Solutions LLC | Clinic/Center | 77 Wellsey Way, Dallas, GA 30132 | 2017-09-14 |
| 1528438413 | Georgia Dental Professionals, PC | Dentist | 8709 Dallas Acworth Hwy, Dallas, GA 30132 | 2015-10-05 |
| 1013256130 | Paulding Auto Sales | Private Vehicle | 210 E Memorial Dr, Dallas, GA 30132 | 2013-02-08 |
| 1255613410 | Matthew Lerandal Talley | Chiropractor | 1305 Cedarcrest Road Suite#111, Dallas, GA 30132 | 2011-09-14 |
| 1003109422 | Ashlyn Drugs | Pharmacy | 1160 Old Harris Rd, Dallas, GA 30132 | 2011-05-18 |
| 1285942086 | Premier Hearing and Health Services Inc | Clinic/Center | 300 W I Parkway Ste 207, Premier Hearing and Health Services Inc, Dallas, GA 30132 | 2010-09-15 |
| 1578878963 | Karen Parris | Speech-Language Pathologist | 283 Red Hawk Way, Dallas, GA 30132 | 2010-08-10 |
| Find all providers in zip 30132 | ||||
| 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 |
|---|---|---|---|---|
| 1174144240 | Saima Ayub | Pharmacist | 6808 Skillman St Apt 5115, Dallas, TX 75231-5825 | 2020-04-30 |
| 1972133999 | Bra'sheika Renee Johnson | Pharmacist | 752 Wynnewood Village S/c, Dallas, TX 75224 | 2020-01-17 |
| 1710492772 | Kimberly Hunton | Pharmacist | 94 Memorial Ct, Dallas, GA 30132-4429 | 2017-12-12 |
| 1245609858 | Heather Eileen Li | Pharmacist | 2830 State St, Dallas, TX 75204 | 2015-09-24 |
| 1104161678 | Hiral Patel | Pharmacist | 4500 S Lancaster Rd Bldg 7r119a, Dallas, TX 75216-7167 | 2012-12-10 |
| 1538419825 | Michael Edward Wright II | Pharmacist | 3500 Gaston Ave., Department of Pharmacy, Dallas, TX 75246 | 2012-09-13 |
| 1366709040 | Tammy Monk James | Pharmacist | 4700 Ross Ave, Dallas, TX 75204-4859 | 2012-04-18 |
| 1427354687 | Kunal Kaushik Patel | Pharmacist | 2901 Indiana Blvd, # 315, Dallas, TX 75226-1520 | 2011-02-07 |
| 1952557985 | Latonya Rena Menefee | Pharmacist | 4500 S Lancaster Rd Bldg 7, Dallas, TX 75216-7167 | 2008-08-11 |
| 1093314049 | Whitney Faith Barth | Pharmacist | 4901 Maple Ave, Dallas, TX 75235-8210 | 2020-10-21 |
| Find all providers in DALLAS | ||||
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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.