NPI 1104196740 · live from the CMS NPI Registry
Boma Agboh-Stroude, PharmD, CGP
Pharmacist, Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist in Marietta, GA. National Provider Identifier 1104196740, active.
NPI record
| NPI | 1104196740 Type 1 · individual |
|---|---|
| Status | Active |
| Primary specialty | Pharmacist, Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist 1835P0018X |
| Practice location | 1401 Johnson Ferry Rd, Marietta, GA 30062 |
| Practice phone | 770-240-0006 |
| Enumerated | January 11, 2012 |
| Last updated | January 11, 2012 |
| Sole proprietor | No |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Pharmacist, Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist | 1835P0018X | 38139 (FL) |
| Pharmacist, Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist | 1835P0018X | 03329232 (OH) |
| Pharmacist, Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist primary | 1835P0018X | 23609 (GA) |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.