NPI age
20 years
Enumerated 2005-10-27
● Active
Type 1 · Individual
DR. Kennon Latrell Tyre III, PHARM.D.
Tyre is 1 of 41 pharmacist providers in Waycross and 1 of 8384 in Georgia.
Primary specialty
Pharmacist
Licensed in
GA
1 state
Status
Active
No deactivations on record
Last NPPES update
2007-07-08
Source: monthly bulk 2026-05
Sole proprietor
Not specified
May be part of a larger org
How this provider compares
Across 8384 active pharmacist providers in Georgia.
NPI age
20 years
↑ 11 yr above median (9 yr)
State licenses
1 state
9% of peers hold multiple states
Subspecialties
0
10% of peers hold subspecialties
NPI lifetime · 2005 → 2026
2005-10Enumerated in NPPES
2005
2026
Where they practice
Practice location
410 Darling Ave, Pharmacy Department
Waycross, GA 315015246
Mailing address
937 Dogwood Dr
Blackshear, GA 315162302
Specialties
-
Pharmacist PrimaryAn 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,...
Identifiers
| Type | Value | Notes |
|---|---|---|
| 01 (GA) | 18517 | GA LICENSE |
Practice context
Part of a multi-provider practice. 27 other active providers share this practice address in NPPES.
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- Confirm the NPI on NPPES.The CMS registry is the system of record. Open NPPES →
- Check the state license is currently active.State licensing boards publish current status; NPPES does not.
- Confirm payer enrollment if billing.NPI presence does not guarantee active enrollment with Medicare, Medicaid, or commercial payers.