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Dr. Kennon Latrell Tyre III, PHARMD
Pharmacist in Waycross, Georgia
NPI 1629068895

Kennon Latrell Tyre III is a Pharmacist based in Blackshear, GA. Kennon Latrell Tyre III practices in Waycross, GA and has the professional credentials of PHARMD. The NPI Number for Kennon Latrell Tyre III is 1629068895 and holds a License No. 18517 (Georgia).

The current practice location address for Kennon Latrell Tyre III is 410 Darling Ave, Waycross, GA and can be reached out via phone at 912-287-2640 and via fax at 912-287-2642.

Location: 410 Darling Ave, Waycross, GA, 31516-2302
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1629068895
Provider Name
Kennon Latrell Tyre III
Credential
PHARMD
Provider Entity Type
Individual
Gender
Male
Address
410 Darling Ave, Waycross, GA, 31516-2302
Phone Number
912-287-2640
Fax Number
912-287-2642
Provider Enumeration Date
10/27/2005
Last Update Date
03/08/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
18517 01 GA GA LICENSE
institution
Provider Business Practice Location Address Details
Address
410 Darling Ave
City
Waycross
State
Georgia
Zip
31501-5246
Phone Number
912-287-2640
Fax Number
912-287-2642
person
Provider Business Mailing Address Details
Address
410 Darling Ave
City
Waycross
State
Georgia
Zip
31501-5246
Phone Number
912-287-2640
Fax Number
912-287-2642
person
Provider's Taxonomy Details 1
Type
Pharmacy Service Providers
Classification
Pharmacist
Speciality
-
Taxonomy
183500000X
License No.
18517 (Georgia)
Definition
An individual licensed by the appropriate state regulatory agency to engage in the practice of pharmacy. The practice of pharmacy includes, but is not limited to, assessment, interpretation, evaluation, and implementation, initiation, monitoring or modification of medication and or medical orders; the compounding or dispensing of medication and or medical orders; participation in drug and device procurement, storage, and selection; drug administration; drug regimen reviews; drug or drug-related research; provision of patient education and the provision of those acts or services necessary to provide medication therapy management services in all areas of patient care.
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