Provider Demographics
NPI:1649874033
Name:TANYI, ANKRA (RPH)
Entity type:Individual
Prefix:
First Name:ANKRA
Middle Name:
Last Name:TANYI
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 1:1196 WOODFIELD TRCE
Mailing Address - Street 2:
Mailing Address - City:LITHONIA
Mailing Address - State:GA
Mailing Address - Zip Code:30058-6077
Mailing Address - Country:US
Mailing Address - Phone:678-923-9704
Mailing Address - Fax:770-788-1293
Practice Address - Street 1:4183 HIGHWAY 278 NE
Practice Address - Street 2:
Practice Address - City:COVINGTON
Practice Address - State:GA
Practice Address - Zip Code:30014-2400
Practice Address - Country:US
Practice Address - Phone:770-385-5282
Practice Address - Fax:770-788-1293
Is Sole Proprietor?:Yes
Enumeration Date:2020-11-25
Last Update Date:2020-11-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA029410183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist