Provider Demographics
NPI:1144491689
Name:PRINE, TONI LYNN (RPH)
Entity type:Individual
Prefix:
First Name:TONI
Middle Name:LYNN
Last Name:PRINE
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2 PEACHTREE ST NW
Mailing Address - Street 2:5TH FLOOR
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30303-3141
Mailing Address - Country:US
Mailing Address - Phone:404-463-7487
Mailing Address - Fax:866-899-9772
Practice Address - Street 1:2 PEACHTREE ST NW
Practice Address - Street 2:5TH FLOOR
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30303-3141
Practice Address - Country:US
Practice Address - Phone:404-463-7487
Practice Address - Fax:866-899-9772
Is Sole Proprietor?:Yes
Enumeration Date:2008-03-12
Last Update Date:2008-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA17877183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA17877OtherSTATE BOARD OF PHARMACY