Provider Demographics
NPI:1023894128
Name:PERKINS, RAQUEL C (PHARMD, RPH)
Entity type:Individual
Prefix:DR
First Name:RAQUEL
Middle Name:C
Last Name:PERKINS
Suffix:
Gender:F
Credentials:PHARMD, RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:365 LAWRENCE PL
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30349-1069
Mailing Address - Country:US
Mailing Address - Phone:678-467-0078
Mailing Address - Fax:
Practice Address - Street 1:800 E WEST CONNECTOR STE 21319
Practice Address - Street 2:
Practice Address - City:AUSTELL
Practice Address - State:GA
Practice Address - Zip Code:30106-1358
Practice Address - Country:US
Practice Address - Phone:770-438-1680
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-09-05
Last Update Date:2023-09-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARPH022516183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist