Provider Demographics
NPI:1497330674
Name:PIRMOHAMED, FAHZILLA (RPH)
Entity Type:Individual
Prefix:
First Name:FAHZILLA
Middle Name:
Last Name:PIRMOHAMED
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1209 N. PEACHTREE PKWY
Mailing Address - Street 2:
Mailing Address - City:PEACHTREE
Mailing Address - State:GA
Mailing Address - Zip Code:30269
Mailing Address - Country:US
Mailing Address - Phone:770-282-2166
Mailing Address - Fax:678-734-3840
Practice Address - Street 1:1209 N. PEACHTREE PKWY
Practice Address - Street 2:
Practice Address - City:PEACHTREE
Practice Address - State:GA
Practice Address - Zip Code:30269
Practice Address - Country:US
Practice Address - Phone:770-282-2166
Practice Address - Fax:678-734-3840
Is Sole Proprietor?:No
Enumeration Date:2021-03-10
Last Update Date:2021-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARPH017644183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist