Provider Demographics
NPI:1114646239
Name:CHAUDHARI, JITENDRA (PHARMACIST)
Entity Type:Individual
Prefix:
First Name:JITENDRA
Middle Name:
Last Name:CHAUDHARI
Suffix:
Gender:M
Credentials:PHARMACIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:933 PEACHTREE ST NE STE 100
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30309-7901
Mailing Address - Country:US
Mailing Address - Phone:770-485-0575
Mailing Address - Fax:
Practice Address - Street 1:1700 HOSPITAL SOUTH DR STE 100
Practice Address - Street 2:
Practice Address - City:AUSTELL
Practice Address - State:GA
Practice Address - Zip Code:30106-8116
Practice Address - Country:US
Practice Address - Phone:770-485-0575
Practice Address - Fax:877-411-0199
Is Sole Proprietor?:No
Enumeration Date:2022-08-23
Last Update Date:2024-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARPH028305183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist