Provider Demographics
NPI:1225585490
Name:GUPTA, ALOK (BPHARM, RPH)
Entity Type:Individual
Prefix:MR
First Name:ALOK
Middle Name:
Last Name:GUPTA
Suffix:
Gender:M
Credentials:BPHARM, RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4088 BILTMORE WOODS CT
Mailing Address - Street 2:
Mailing Address - City:BUFORD
Mailing Address - State:GA
Mailing Address - Zip Code:30519-6906
Mailing Address - Country:US
Mailing Address - Phone:404-819-3506
Mailing Address - Fax:
Practice Address - Street 1:4088 BILTMORE WOODS CT
Practice Address - Street 2:
Practice Address - City:BUFORD
Practice Address - State:GA
Practice Address - Zip Code:30519-6906
Practice Address - Country:US
Practice Address - Phone:404-819-3506
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-09-06
Last Update Date:2016-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA0168511835X0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835X0200XPharmacy Service ProvidersPharmacistOncology