Provider Demographics
NPI:1497052674
Name:TRABOOKIS, BRADLEY CHRISTOPHER (PHARMD)
Entity Type:Individual
Prefix:MR
First Name:BRADLEY
Middle Name:CHRISTOPHER
Last Name:TRABOOKIS
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3033 JOHNSON FERRY RD
Mailing Address - Street 2:
Mailing Address - City:MARIETTA
Mailing Address - State:GA
Mailing Address - Zip Code:30062-5678
Mailing Address - Country:US
Mailing Address - Phone:770-518-4263
Mailing Address - Fax:
Practice Address - Street 1:3033 JOHNSON FERRY RD
Practice Address - Street 2:
Practice Address - City:MARIETTA
Practice Address - State:GA
Practice Address - Zip Code:30062-5678
Practice Address - Country:US
Practice Address - Phone:770-518-4263
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-02-23
Last Update Date:2016-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC12541183500000X
NC20589183500000X
GARPH025081183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist