Provider Demographics
NPI:1114522794
Name:SHEGER PHARMACY LLC
Entity Type:Organization
Organization Name:SHEGER PHARMACY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:DAWIT
Authorized Official - Middle Name:T
Authorized Official - Last Name:ANTONIOS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:770-674-4800
Mailing Address - Street 1:3334 STONE MOUNTAIN HWY STE H
Mailing Address - Street 2:
Mailing Address - City:SNELLVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30078-4166
Mailing Address - Country:US
Mailing Address - Phone:770-674-4800
Mailing Address - Fax:770-559-1838
Practice Address - Street 1:3334 STONE MOUNTAIN HWY STE H
Practice Address - Street 2:
Practice Address - City:SNELLVILLE
Practice Address - State:GA
Practice Address - Zip Code:30078-4166
Practice Address - Country:US
Practice Address - Phone:770-674-4800
Practice Address - Fax:770-559-1838
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-12-02
Last Update Date:2021-05-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy